心跳變異生理反饋:如何及為何能發揮作用?(下) | Heart rate variability biofeedback: how and why does it work?
心跳變異生理反饋:如何及為何能發揮作用?
Heart rate variability biofeedback: how and why does it work?
其他潛在治療作用機制
由於HRV生理反饋顯然對涉及各種生理系統的病症(疼痛、焦慮、抑鬱、慢性阻塞性肺病、血壓控制、運動表現等)有幫助,因此除了感壓感反射之外,很可能還涉及多種機制以產生各種影響。副交感神經傳入的刺激和影響,大部分尚未受到實證關注,但它們都相當值得進行研究,這些可能機制包括:
副交感神經傳出影響
副交感神經活動通常是“放鬆反應”的一個組成部分。HRV反饋刺激副交感神經反射可能會產生具放鬆特點的身體自主活動,進而直接對抗壓力效應。可能發生此一情況的一種方式是被稱為“強化對抗(Accentuated Antagonism)”的機制。副交感神經的音調在休息時主導了交感神經。在正常生理條件下,突然而來的副交感神經刺激會抑制強直性交感神經的啟動及其在休息和運動時的作用,這種反應就是前面所提到的”強化對抗” (Olshansky et al., 2008, p. 863)。根據推測,副交感傳出系統的這一方面可以透過HRVB訓練得到加強,這可能可以抑制交感神經向肌筋膜激痛點的輸出(Hubbard and Berkoff, 1993; Gevirtz et al., 1996; Hubbard, 1998)。倫敦Aziz研究小組(Hobson et al., 2008)的研究也證實,當酸進入胃時,緩慢呼吸幾乎可以立即讓食道疼痛閾值急劇下降。
提升氣體交換率
由於諧振頻率呼吸期間呼吸與心率之間存在0°相位關係,改善氣體交換可能有助於患有呼吸系統疾病的人,甚至可能降低患有壓力引發過度換氣(Stress-Induced Hyperventilatory)反應者的呼吸動力。
冥想效果
心率變異性生理反饋涉及密切關注呼吸的細微差別。這與正念冥想練習中的做法非常相似。這裡的途徑主要是精神上的:也就是個體不能在專注放鬆呼吸的同時去擔心一天當中的各種問題。
呼吸道的機械彈性
對哮喘的影響可能是深呼吸伸展了肺部上皮組織作用間接發生的。已知在肺可靈激發試劑(methacholine)檢驗過程中,僅單次深吸即可降低哮喘患者氣道對試劑反應性(Pellegrino et al., 1996; Marchal et al., 2002)。
抗炎作用
副交感神經系統與炎症系統有著密切相互作用,因此副交感神經通路增加(一般經由副交感神經電刺激產生)與血清中的各種炎症細胞激素含量降低相關(Borovikova et al., 2000; Tracey, 2002)。一項研究已發現高血壓患者接受HRV生理反饋治療後的C反應蛋白有所減少(Nolan et al., 2012)。另一項研究中則是在實驗內將健康受試者暴露於炎症細胞激素脂多醣當中(Lehrer et al., 2010)。一般來說,交感神經和副交感神經的活性都會被脂多醣所阻斷。雖然並未發現HRV生理反饋誘導下讓炎症細胞激素減少,但發現炎症自主神經效應受到極大調節,表示有接受HRV 生理反饋的個體存有更大的彈性。
結論
本文試圖總結有效性的可能機制,建立假設討論感壓反射增加即為自主神經穩態改善或複雜性增加的可行標誌。對於此一結論進行一系列證據回顧,這些證據經由本文實驗室及其他研究者證實,因此可推測與此類機制相結合下,副交感神經傳入系統的刺激也可能發揮作用,特別是在消極情感障礙當中。
利益衝突聲明 : 作者聲明本研究是在不存在任何可能被視為潛在利益衝突的商業或財務關係情況下進行。
文獻回顧
- Ahmad S., Tejuja A., Newman K. D., Zarychanski R., Seely A. J. (2009). Clinical review: a review and analysis of heart rate variability and the diagnosis and prognosis of infection. Care13:232 10.1186/cc8132
- Arnold A. C., Shaltout H. A., Gallagher P. E., Diz D. I. (2009). Leptin impairs cardiovagal baroreflex function at the level of the solitary tract nucleus. Hypertension54 1001–1008 10.1161/HYPERTENSIONAHA.109.138065
- Badra L. J., Cooke W. H., Hoag J. B., Crossman A. A., Kuusela T. A., Tahvanainen K. U., et al. (2001). Respiratory modulation of human autonomic rhythms. J. Physiol. Heart Circ. Physiol.280 H2674–H2688
- Başar E. (1998). “Resonance phenomena in the brain, physical systems, and nature,” in Brain Functions and OscillationsBaşar E. (Berlin: Springer Verlag; ). 10.1007/978-3-642-72192-2
- Berntson G. G., Bigger J. T., Jr., Eckberg D. L., Grossman P., Kaufmann P. G., Malik M., et al. (1997). Heart rate variability: origins, methods, and interpretive caveats. Psychophysiology34 623–648 10.1111/j.1469-8986.1997.tb02140.x
- Borovikova L. V., Ivanova S., Zhang M., Yang H., Botchkina G. I., Watkins L. R., et al. (2000). Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin. Nature405 458–462 10.1038/35013070
- Boutcher S. H., Park Y., Dunn S. L., Boutcher Y. N. (2013). The relationship between cardiac autonomic function and maximal oxygen uptake response to high-intensity intermittent-exercise training. Sports Sci.31 1024–1029 10.1080/02640414.2012.762984
- Brown R. P., Gerbarg P. L. (2005a). Sudarshan Kriya Yogic breathing in the treatment of stress, anxiety, and depression. Part II – clinical applications and guidelines. Altern. Complement. Med.11 711–717 10.1089/acm.2005.11.711
- Brown R. P., Gerbarg P. L. (2005b). Sudarshan Kriya yogic breathing in the treatment of stress, anxiety, and depression: part I-neurophysiologic model. Altern. Complement. Med.11 189–201 10.1089/acm.2005.11.189
- Brown R. P., Gerbarg P. L., Muench F. (2013). Breathing practices for treatment of psychiatric and stress-related medical conditions. Cliin. North Am.36 121–140 10.1016/j.psc.2013.01.001
- Brown T. E., Beightol L. A., Koh J., Eckberg D. L. (1993). Important influence of respiration on human R-R interval power spectra is largely ignored. Appl. Physiol.75 2310–2317
- Carney R. M., Freedland K. E. (2009). Depression and heart rate variability in patients with coronary heart disease. Cliin. J. Med.76(Suppl. 2), S13–S17 10.3949/ccjm.76.s2.03
- Chan C. T. (2008). Heart rate variability in patients with end-stage renal disease: an emerging predictive tool for sudden cardiac death? Dial. Transplant.23 3061–3062 10.1093/ndt/gfn280
- Christensen J. H. (2012). Cardiac autonomic dysfunction in hemodialysis patients assessed by heart rate variability. Minerva Urol. Nefrol.64 191–198 10.1111/j.1542-4758.2011.00529.x
- Cristancho P., Cristancho M. A., Baltuch G. H., Thase M. E., O’Reardon J. P. (2011). Effectiveness and safety of vagus nerve stimulation for severe treatment-resistant major depression in Clinical practice after FDA approval: outcomes at 1 year. Clin. Psychiatry72 1376–1382 10.4088/JCP.09m05888blu
- Critchley H. D., Wiens S., Rotshtein P., Ohman A., Dolan R. J. (2004). Neural systems supporting interoceptive awareness. Neurosci.7 189–195 10.1038/nn1176
- Daban C., Martinez-Aran A., Cruz N., Vieta E. (2008). Safety and efficacy of Vagus Nerve Stimulation in treatment-resistant depression. A systematic review. Affect. Disord.110 1–15 10.1016/j.jad.2008.02.012
- De Meersman R. E. (1993). Heart rate variability and aerobic fitness. Heart. J.125 726–731 10.1016/0002-8703(93)90164-5
- Eckberg D. L. (2003). The human respiratory gate. Physiol.548(Pt 2), 339–352 10.1113/jphysiol.2002.037192
- Eckberg D. L., Nerhed C., Wallin B. G. (1985). Respiratory modulation of muscle sympathetic and vagal cardiac outflow in man. Physiol.365181–196
- Eckberg D. L., Sleight P. (1992). Human Baroreflexes in Health and Disease.Oxford: Clarendon Press
- Fleisher L. A., Frank S. M., Sessler D. I., Cheng C., Matsukawa T., Vannier C. A. (1996). Thermoregulation and heart rate variability. Sci.90 97–103
- Friedman B. H., Thayer J. F. (1998). Autonomic balance revisited: panic anxiety and heart rate variability. Psychosom. Res.44 133–151 10.1016/S0022-3999(97)00202-X
- Fukusaki C., Kawakubo K., Yamamoto Y. (2000). Assessment of the primary effect of aging on heart rate variability in humans. Auton. Res.10 123–130 10.1007/BF02278016
- n P. T., Pollack M., Nahas Z., Anderson B., et al. (2008). A pilot study of vagus nerve stimulation (VNS) for treatment-resistant anxiety disorders. Brain Stimul.1 112–121 10.1016/j.brs.2008.02.001
- Gevirtz R. (2013). The promise of heart rate variability biofeedback: evidence-based applications. Biofeedback41 110–120 10.5298/1081-5937-41.3.01
- Gevirtz R., Hubbard D., Harpin E. (1996). Psychophysiologic treatment of chronic low back pain. Psychol. Res. Pract.27 561–566 10.1037/0735-7028.27.6.561
- Giardino N. D., Chan L., Borson S. (2004). Combined heart rate variability and pulse oximetry biofeedback for chronic obstructive pulmonary disease: preliminary findings. Psychophysiol. Biofeedback29 121–133 10.1023/B:APBI.0000026638.64386.89
- Gorman J. M., Sloan R. P. (2000). Heart rate variability in depressive and anxiety disorders. Heart. J.140(4 Suppl.), 77–83 10.1067/mhj.2000.109981
- Gray M. A., Taggart P., Sutton P. M., Groves D., Holdright D. R., Bradbury D., et al. (2007). A cortical potential reflecting cardiac function. Natl. Acad. Sci. U.S.A.104 6818–6823 10.1073/pnas.0609509104
- Grossman P., Karemaker J., Wieling W. (1991). Prediction of tonic parasympathetic cardiac control using respiratory sinus arrhythmia: the need for respiratory control. Psychophysiology28 201–216 10.1111/j.1469-8986.1991.tb00412.x
- Grundy D. (2002). Neuroanatomy of visceral nociception: vagal and splanchnic afferent. Gut51(Suppl. 1), i2–i5 10.1136/gut.51.suppl_1.i2
- Handa R., Poanta L., Rusu D., Albu A. (2012). The role of heart rate variability in assessing the evolution of patients with chronic obstructive pulmonary disease. J. Intern. Med.50 83–88
- Hautala A. J., Makikallio T. H., Kiviniemi A., Laukkanen R. T., Nissila S., Huikuri H. V., et al. (2003). Cardiovascular autonomic function correlates with the response to aerobic training in healthy sedentary subjects. J. Physiol. Heart Circ. Physiol.285 H1747–H1752 10.1152/ajpheart.00202.2003
- Hayano J., Yasuma F., Okada A., Mukai S., Fujinami T. (1996). Respiratory sinus arrhythmia: a phenomenon improving pulmonary gas exchange and circulatory efficiency. Circulation94 842–847 10.1161/01.CIR.94.4.842
- Henderson L. A., Richard C. A., Macey P. M., Runquist M. L., Yu P. L., Galons J. P., et al. (2004). Functional magnetic resonance signal changes in neural structures to baroreceptor reflex activation. Appl. Physiol.96 693–703 10.1152/japplphysiol.00852.2003
- Henriques G., Keffer S., Abrahamson C., Horst S. J. (2011). Exploring the effectiveness of a computer-based heart rate variability biofeedback program in reducing anxiety in college students. Psychophysiol. Biofeedback36 101–112 10.1007/s10484-011-9151-4
- Huang C., Gevirtz R., Onton J., Criado J. (2014). Investigation of vagal afferent functioning using heartbeat event related potentials. Paper Presented at the 45th Annual Meeting of the Association for Applied Psychophysiology and BiofeedbackSavannah, GA
- Hobson A. R., Furlong P. L., Aziz Q. (2008). Oesophageal afferent pathway sensitivity in non-erosive reflux disease. Motil.20 877–883 10.1111/j.1365-2982.2008.01122.x
- Hubbard D. (1998). Persistent muscular pain: approaches to relieving trigger points. Musculoskelat. Med.15 16–26
- Hubbard D. R., Berkoff G. M. (1993). Myofascial trigger points show spontaneous needle EMG activity. Spine18 1803–1807 10.1097/00007632-199310000-00015
- Huikuri H. V., Perkiomaki J. S., Maestri R., Pinna G. D. (2009). Clinical impact of evaluation of cardiovascular control by novel methods of heart rate dynamics. Trans. R. Soc. Lond. A Math. Phys. Eng. Sci.367 1223–1238 10.1098/rsta.2008.0294
- Huikuri H. V., Stein P. K. (2013). Heart rate variability in risk stratification of cardiac patients. Cardiovasc. Dis.56 153–159 10.1016/j.pcad.2013.07.003
- Ivanov P. C., Amaral L. A., Goldberger A. L., Havlin S., Rosenblum M. G., Struzik Z. R., et al. (1999). Multifractality in human heartbeat dynamics. Nature399 461–465 10.1038/20924
- Karavidas M. K., Lehrer P. M., Vaschillo E., Vaschillo B., Marin H., Buyske S., et al. (2007). Preliminary results of an open label study of heart rate variability biofeedback for the treatment of major depression. Psychophysiol. Biofeedback32 19–30 10.1007/s10484-006-9029-z
- Kemp A. H., Quintana D. S., Gray M. A., Felmingham K. L., Brown K., Gatt J. M. (2010). Impact of depression and antidepressant treatment on heart rate variability: a review and meta-analysis. Psychiatry67 1067–1074 10.1016/j.biopsych.2009.12.012
- Kudaiberdieva G., Gorenek B., Timuralp B. (2007). Heart rate variability as a predictor of sudden cardiac death. Kardiyol. Derg.7(Suppl. 1),68–70
- Laitio T., Jalonen J., Kuusela T., Scheinin H. (2007). The role of heart rate variability in risk stratification for adverse postoperative cardiac events. Analg.105 1548–1560 10.1213/01.ane.0000287654.49358.3a
- Lehrer P., Eddie D. (2013). Dynamic processes in regulation and some implications for biofeedback and biobehavioral interventions. Psychophysiol. Biofeedback38 143–155 10.1007/s10484-013-9217-6
- Lehrer P., Karavidas M. K., Lu S.-E., Coyle S. M., Oikawa L. O., Macor M., et al. (2010). Voluntarily produced increases in heart rate variability modulate autonomic effects of endotoxin induced systemic inflammation: an exploratory study. Psychophysiol. Biofeedback35 303–315 10.1007/s10484-010-9139-5
- Lehrer P. M., Vaschillo E., Vaschillo B. (2000). Resonant frequency biofeedback training to increase cardiac variability: rationale and manual for training. Psychophyisol. Biofeedback25 177–191 10.1023/A:1009554825745
- Lehrer P. M., Vaschillo E., Vaschillo B., Lu S. E., Eckberg D. L., Edelberg R., et al. (2003). Heart rate variability biofeedback increases baroreflex gain and peak expiratory flow. Med.65 796–805 10.1097/01.PSY.0000089200.81962.19
- Lehrer P., Sasaki Y., Saito Y. (1999). Zazen and cardiac variability. Med.61 812–821 10.1097/00006842-199911000-00014
- Lehrer P., Vaschillo E., Trost Z., France C. R. (2009). Effects of rhythmical muscle tension at 0.1 Hz on cardiovascular resonance and the baroreflex. Psychol.81 24–30 10.1016/j.biopsycho.2009.01.003
- Lin G., Xiang Q., Fu X., Wang S., Wang S., Chen S., et al. (2012). Heart rate variability biofeedback decreases blood pressure in prehypertensive subjects by improving autonomic function and baroreflex. Altern. Complement. Med.18 143–152 10.1089/acm.2010.0607
- MacKinnon S., Gevirtz R., McCraty R., Brown M. (2013). Utilizing heartbeat evoked potentials to identify cardiac regulation of vagal afferents during emotion and resonant breathing. Psychophysiol. Biofeedback38 241–255 10.1007/s10484-013-9226-5
- Marchal F., Schweitzer C., Moreau-Colson C. (2002). Respiratory impedance response to a deep inhalation in children with history of cough or asthma. Pulmonol.33 411–418 10.1002/ppul.10093
- Matsumoto T., Miyawaki T., Ue H., Kanda T., Zenji C., Moritani T. (1999). Autonomic responsiveness to acute cold exposure in obese and non-obese young women. J. Obes. Relat. Metab. Disord.23 793–800 10.1038/sj.ijo.0800928
- McCraty R., Atkinson M., Lipsenthal L., Arguelles L. (2009). New hope for correctional officers: an innovative program for reducing stress and health risks. Psychophysiol. Biofeedback34 251–272 10.1007/s10484-009-9087-0
- McNarry M. A., Lewis M. J. (2012). Interaction between age and aerobic fitness in determining heart rate dynamics. Meas.33 901–914 10.1088/0967-3334/33/6/901
- Montoya P., Schandry R., Muller A. (1993). Heartbeat evoked potentials (HEP): topography and influence of cardiac awareness and focus of attention. Clin. Neurophysiol.88 163–172 10.1016/0168-5597(93)90001-6
- Nada P. J. (2009). Heart rate variability in the assessment and biofeedback training of common mental health problems in children. Arh.63 244–248
- Nahas Z., Marangell L. B., Husain M. M., Rush A. J., Sackeim H. A., Lisanby S. H., et al. (2005). Two-year outcome of vagus nerve stimulation (VNS) for treatment of major depressive episodes. Cliin. Psychiatry66 1097–1104 10.4088/JCP.v66n0902
- Nolan R. P., Floras J. S., Ahmed L., Harvey P. J., Hiscock N., Hendrickx H., et al. (2012). Behavioural modification of the cholinergic anti-inflammatory response to c-reactive protein in patients with hypertension. Intern. Med.272 161–169 10.1111/j.1365-2796.2012.02523.x
- Nolan R. P., Floras J. S., Harvey P. J., Kamath M. V., Picton P. E., Chessex C., et al. (2010). Behavioral neurocardiac training in hypertension: a randomized, controlled trial. Hypertension55 1033–1039 10.1161/HYPERTENSIONAHA.109.146233
- Nunan D., Sandercock G. R., Brodie D. A. (2010). A quantitative systematic review of normal values for short-term heart rate variability in healthy adults. Pacing Clin. Electrophysiol.33 1407–1417 10.1111/j.1540-8159.2010.02841.x
- Olshansky B., Sabbah H. N., Hauptman P. J., Colucci W. S. (2008). Parasympathetic nervous system and heart failure: pathophysiology and potential implications for therapy. Circulation118 863–871 10.1161/CIRCULATIONAHA.107.760405
- Otsuka K., Cornelissen G., Halberg F. (1997). Circadian rhythmic fractal scaling of heart rate variability in health and coronary artery disease. Cardiol.20 631–638 10.1002/clc.4960200710
- Passino C., Sleight P., Valle F., Spadacini G., Leuzzi S., Bernardi L. (1997). Lack of peripheral modulation of cardiovascular central oscillatory autonomic activity during apnea in humans. J. Physiol.272(1Pt 2), H123–H129
- Patron E., Messerotti Benvenuti S., Favretto G., Valfre C., Bonfa C., Gasparotto R., et al. (2013). Biofeedback assisted control of respiratory sinus arrhythmia as a biobehavioral intervention for depressive symptoms in patients after cardiac surgery: a preliminary study. Psychophysiol. Biofeedback38 1–9 10.1007/s10484-012-9202-5
- Paul M., Garg K. (2012). The effect of heart rate variability biofeedback on performance psychology of basketball players. Psychophysiol. Biofeedback37 131–144 10.1007/s10484-012-9185-2
- Pellegrino R., Violante B., Brusasco V. (1996). Maximal bronchoconstriction in humans. Relationship to deep inhalation and airway sensitivity. J. Respir. Crit. Care Med.153 115–121 10.1164/ajrccm.153.1.8542103
- Pikkujamsa S. M., Makikallio T. H., Sourander L. B., Raiha I. J., Puukka P., Skytta J., et al. (1999). Cardiac interbeat interval dynamics from childhood to senescence : comparison of conventional and new measures based on fractals and chaos theory. Circulation100 393–399 10.1161/01.CIR.100.4.393
- Politano L., Palladino A., Nigro G., Scutifero M., Cozza V. (2008). Usefulness of heart rate variability as a predictor of sudden cardiac death in muscular dystrophies. Acta Myol.27 114–122
- Pollatos O., Kirsch W., Schandry R. (2005a). Brain structures involved in interoceptive awareness and cardioafferent signal processing: a dipole source localization study. Brain Mapp.26 54–64 10.1002/hbm.20121
- Pollatos O., Kirsch W., Schandry R. (2005b). On the relationship between interoceptive awareness, emotional experience, and brain processes. Brain Res. Cogn. Brain Res.25 948–962 10.1016/j.cogbrainres.2005.09.019
- Polson J. W., Dampney R. A., Boscan P., Pickering A. E., Paton J. F. (2007). Differential baroreflex control of sympathetic drive by angiotensin II in the nucleus tractus solitarii. J. Physiol. Regul. Integr. Comp. Physiol.293 R1954–R1960 10.1152/ajpregu.00041.2007
- Porges S. (2011). The Polyvagal theory.New York: W. W. Norton & Company
- Ranpuria R., Hall M., Chan C. T., Unruh M. (2008). Heart rate variability (HRV) in kidney failure: measurement and consequences of reduced HRV. Dial. Transplant.23 444–449 10.1093/ndt/gfm634
- Raven P. B., Potts J. T., Shi X. (1997). Baroreflex regulation of blood pressure during dynamic exercise. Sport Sci. Rev.25 365–389 10.1249/00003677-199700250-00015
- Reiner R. (2008). Integrating a portable biofeedback device into Clinical practice for patients with anxiety disorders: results of a pilot study. Psychophysiol. Biofeedback33 55–61 10.1007/s10484-007-9046-6
- Rogers R. F., Rybak I. A., Schwaber J. S. (2000). Computational modeling of the baroreflex arc: nucleus tractus solitarius. Brain Res. Bull.51 139–150 10.1016/S0361-9230(99)00242-7
- Sackeim H. A., Keilp J. G., Rush A. J., George M. S., Marangell L. B., Dormer J. S., et al. (2001a). The effects of vagus nerve stimulation on cognitive performance in patients with treatment-resistant depression. Neuropsychiatry Neuropsychol. Behav. Neurol.14 53–62
- Sackeim H. A., Rush A. J., George M. S., Marangell L. B., Husain M. M., Nahas Z., et al. (2001b). Vagus nerve stimulation (VNS) for treatment-resistant depression: efficacy, side effects, and predictors of outcome. Neuropsychopharmacology25 713–728 10.1016/S0893-133X(01)00271-8
- Schandry R. (1981). Heart beat perception and emotional experience. Psychophysiology18 483–488 10.1111/j.1469-8986.1981.tb02486.x
- Schandry R. (2003). [From the heart to the brain]. Med. Wochenschr.128 2707–2711 10.1055/s-2003-812550
- Schandry R., Sparrer B., Weitkunat R. (1986). From the heart to the brain: a study of heartbeat contingent scalp potentials. J. Neurosci.30 261–275 10.3109/00207458608985677
- Shaw L. (2011). Setting the balance: assessment of a biofeedback intervention for improving competitive performance with a Division 1 gymnastics beam team. Abstr. Int. B Sci. Eng.71:4496
- Siepmann M., Aykac V., Unterdorfer J., Petrowski K., Mueck-Weymann M. (2008). A pilot study on the effects of heart rate variability biofeedback in patients with depression and in healthy subjects. Psychophysiol. Biofeedback33 195–201 10.1007/s10484-008-9064-z
- Skinner J. E., Anchin J. M., Weiss D. N. (2008a). Nonlinear analysis of the heartbeats in public patient ECGs using an automated PD2i algorithm for risk stratification of arrhythmic death. Cliin. Risk Manag.4549–557
- Skinner J. E., Meyer M., Dalsey W. C., Nester B. A., Ramalanjaona G., O’Neil B. J., et al. (2008b). Risk stratification for arrhythmic death in an emergency department cohort: a new method of nonlinear PD2i analysis of the ECG. Clin. Risk Manag.4 689–697
- Skinner J. E., Meyer M., Nester B. A., Geary U., Taggart P., Mangione A., et al. (2009). Comparison of linear-stochastic and nonlinear-deterministic algorithms in the analysis of 15-minute Clinical ECGs to predict risk of arrhythmic death. Clin. Risk Manag.5 671–682 10.2147/TCRM.S5568
- Song H. S., Lehrer P. M. (2003). The effects of specific respiratory rates on heart rate and heart rate variability. Psychophysiol. Biofeedback28 13–24 10.1023/A:1022312815649
- Srinivasan K., Ashok M., Vaz M., Yeragani V. K. (2002). Decreased chaos of heart rate time series in children of patients with panic disorder. Anxiety15 159–167 10.1002/da.10046
- Stein K. M. (2008). Noninvasive risk stratification for sudden death: signal-averaged electrocardiography, nonsustained ventricular tachycardia, heart rate variability, baroreflex sensitivity, and QRS duration. Cardiovasc. Dis.51 106–117 10.1016/j.pcad.2007.10.001
- Strack B. W. (2003). Effect of heart rate variability (hrv) biofeedback on batting performance in baseball. Abstr. Int. B Sci. Eng.64:1540
- Strauss-Blasche G., Moser M., Voica M., McLeod D. R., Klammer N., Marktl W. (2000). Relative timing of inspiration and expiration affects respiratory sinus arrhythmia. Exp. Pharmacol. Physiol.27 601–606 10.1046/j.1440-1681.2000.03306.x
- Tan G., Dao T. K., Farmer L., Sutherland R. J., Gevirtz R. (2011). Heart rate variability (HRV) and posttraumatic stress disorder (PTSD): a pilot study. Psychophysiol. Biofeedback36 27–35 10.1007/s10484-010-9141-y
- Thayer J. F., Nabors-Oberg R., Sollers J. J., III (1997). Thermoregulation, and cardiac variability: a time-frequency analysis. Sci. Instrum.34 252–256
- Thayer J. F., Yamamoto S. S., Brosschot J. F. (2010). The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. J. Cardiol.141 122–131 10.1016/j.ijcard.2009.09.543
- Tracey K. J. (2002). The inflammatory reflex. Nature420 853–859 10.1038/nature01321
- Valentini M., Parati G. (2009). Variables influencing heart rate. Cardiovasc. Dis.52 11–19 10.1016/j.pcad.2009.05.004
- Van de Louw A., Médigue C., Papelier Y., Landrain M., Cottin F. (2010). Role of brainstem centers in cardiorespiratory phase difference during mechanical ventilation. Physiol. Neurobiol.174 119–127 10.1016/j.resp.2010.04.014
- Vaschillo E. G., Bates M. E., Vaschillo B., Lehrer P., Udo T., Mun E. Y., et al. (2008). Heart rate variability response to alcohol, placebo, and emotional picture cue challenges: effects of 0.1-Hz stimulation. Psychophysiology45 847–858 10.1111/j.1469-8986.2008.00673.x
- Vaschillo E. G., Vaschillo B., Buckman J. F., Pandina R. J., Bates M. E. (2012). Measurement of vascular tone and stroke volume baroreflex gain. Psychophysiology49 193–197 10.1111/j.1469-8986.2011.01305.x
- Vaschillo E. G., Vaschillo B., Lehrer P. M. (2006). Characteristics of resonance in heart rate variability stimulated by biofeedback. Psychophysiol. Biofeedback31 129–142 10.1007/s10484-006-9009-3
- Vaschillo E. G., Vaschillo B., Pandina R. J., Bates M. E. (2011). Resonances in the cardiovascular system caused by rhythmical muscle tension. Psychophysiology48 927–936 10.1111/j.1469-8986.2010.01156.x
- Vaschillo E., Lehrer P., Rishe N., Konstantinov M. (2002). Heart rate variability biofeedback as a method for assessing baroreflex function: a preliminary study of resonance in the cardiovascular system. Psychophysiol. Biofeedback27 1–27 10.1023/A:1014587304314
- Volz H. P., Rehbein G., Triepel J., Knuepfer M. M., Stumpf H., Stock G. (1990). Afferent connections of the nucleus centralis amygdalae. A horseradish peroxidase study and literature survey. Embryol.181 177–194 10.1007/BF00198957
- Wang S. Z., Li S., Xu X. Y., Lin G. P., Shao L., Zhao Y., et al. (2010). Effect of slow abdominal breathing combined with biofeedback on blood pressure and heart rate variability in prehypertension. Altern. Complement. Med.16 1039–1045 10.1089/acm.2009.0577
- Weaver R. L., Lobkis O. I. (2006). On the linewidth of the ultrasonic Larsen effect in a reverberant body. Acoust. Soc. Am.120 102–109 10.1121/1.2205128
- Yeragani V. K., Rao K., Smitha M., Pohl R. B., Balon R., Srinivasan K. (2002). Diminished chaos of heart rate time series in patients with major depression. Psychiatry51 733–744 10.1016/S0006-3223%2801%2901347-6
- Zucker T. L., Samuelson K. W., Muench F., Greenberg M. A., Gevirtz R. N. (2009). The effects of respiratory sinus arrhythmia biofeedback on heart rate variability and posttraumatic stress disorder symptoms: a pilot study. Psychophysiol. Biofeedback34 135–143 10.1007/s10484-009-9085-2
Add Comment
You must be logged in to post a comment.