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Tosti B, Corrado S, Mancone S, Di Libero T, Rodio A, Andrade A, Diotaiuti P. Integrated use of biofeedback and neurofeedback techniques in treating pathological conditions and improving performance: a narrative review. Front Neurosci 2024; 18:1358481. [PMID: 38567285 PMCID: PMC10985214 DOI: 10.3389/fnins.2024.1358481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
In recent years, the scientific community has begun tо explore the efficacy оf an integrated neurofeedback + biofeedback approach іn various conditions, both pathological and non-pathological. Although several studies have contributed valuable insights into its potential benefits, this review aims tо further investigate its effectiveness by synthesizing current findings and identifying areas for future research. Our goal іs tо provide a comprehensive overview that may highlight gaps іn the existing literature and propose directions for subsequent studies. The search for articles was conducted on the digital databases PubMed, Scopus, and Web of Science. Studies to have used the integrated neurofeedback + biofeedback approach published between 2014 and 2023 and reviews to have analyzed the efficacy of neurofeedback and biofeedback, separately, related to the same time interval and topics were selected. The search identified five studies compatible with the objectives of the review, related to several conditions: nicotine addiction, sports performance, Autism Spectrum Disorder (ASD), and Attention Deficit Hyperactivity Disorder (ADHD). The integrated neurofeedback + biofeedback approach has been shown to be effective in improving several aspects of these conditions, such as a reduction in the presence of psychiatric symptoms, anxiety, depression, and withdrawal symptoms and an increase in self-esteem in smokers; improvements in communication, imitation, social/cognitive awareness, and social behavior in ASD subjects; improvements in attention, alertness, and reaction time in sports champions; and improvements in attention and inhibitory control in ADHD subjects. Further research, characterized by greater methodological rigor, is therefore needed to determine the effectiveness of this method and the superiority, if any, of this type of training over the single administration of either. This review іs intended tо serve as a catalyst for future research, signaling promising directions for the advancement оf biofeedback and neurofeedback methodologies.
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Affiliation(s)
- Beatrice Tosti
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Stefano Corrado
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Tommaso Di Libero
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Angelo Rodio
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Alexandro Andrade
- Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
| | - Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
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Dynamics of Physiological, Biochemical and Psychological Markers during Single Session of Virtual Reality-Based Respiratory Biofeedback Relaxation. Behav Sci (Basel) 2022; 12:bs12120482. [PMID: 36546965 PMCID: PMC9774569 DOI: 10.3390/bs12120482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/02/2022] Open
Abstract
Psychological stress exposure is associated with long-lasting health effects including memory problems, depression, aches and pains, eating disorders, and alcohol or drug use. Thus, there is a need to develop effective stress management strategies that are easy to learn and practice. Respiratory biofeedback is an evidence-based stress management technique presenting breathing-related information to help subjects learn specific breathing skills for relaxation. It is suggested that the use of biofeedback techniques in conjunction with virtual reality makes biofeedback training an even more effective tool for stress management. The current study aimed to investigate dynamics of distinct stress indicators before, after, as well as during one brief virtual reality-based respiratory biofeedback session. Thirty-nine healthy volunteers participated in the study. Individuals provided their saliva samples and evaluated their mood status, fatigue, and strain level before and after the session. The subjects' heart and respiratory rate, heart rate variability, and galvanic skin response measures were recorded during the session. The results showed that after single 12 min relaxation session, there was a significant decrease in salivary cortisol concentration, heart and respiratory rate, as well as decrease in skin conductance values. Self-reported strain, fatigue level, and mood status also significantly improved. VR-based respiratory-biofeedback-assisted relaxation sessions might serve as an effective stress management strategy, as even single session had positive effects on subjects' autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis activity, as well as self-reported fatigue, strain level, and mood status.
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Model-based assessment of cardiopulmonary autonomic regulation in paced deep breathing. Methods 2022; 204:312-318. [PMID: 35447359 DOI: 10.1016/j.ymeth.2022.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/12/2022] [Accepted: 04/14/2022] [Indexed: 11/21/2022] Open
Abstract
Autonomic dysfunction can lead to many physical and psychological diseases. The assessment of autonomic regulation plays an important role in the prevention, diagnosis, and treatment of these diseases. A physiopathological mathematical model for cardiopulmonary autonomic regulation, namely Respiratory-Autonomic-Sinus (RSA) regulation Model, is proposed in this study. A series of differential equations are used to simulate the whole process of RSA phenomenon. Based on this model, with respiration signal and ECG signal simultaneously acquired in paced deep breathing scenario, we manage to obtain the cardiopulmonary autonomic regulation parameters (CARP), including the sensitivity of respiratory-sympathetic nerves and respiratory-parasympathetic nerves, the time delay of sympathetic, the sensitivity of norepinephrine and acetylcholine receptor, as well as cardiac remodeling factor by optimization algorithm. An experimental study has been conducted in healthy subjects, along with subjects with hypertension and coronary heart disease. CARP obtained in the experiment have shown their clinical significance.
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Dehdar K, Mahdidoust S, Salimi M, Gholami-Mahtaj L, Nazari M, Mohammadi S, Dehghan S, Jamaati H, Khosrowabadi R, Nasiraei-Moghaddam A, Barkley V, Javan M, Mirnajafi-Zadeh J, Sumiyoshi A, Raoufy MR. Allergen-induced anxiety-like behavior is associated with disruption of medial prefrontal cortex - amygdala circuit. Sci Rep 2019; 9:19586. [PMID: 31863052 PMCID: PMC6925103 DOI: 10.1038/s41598-019-55539-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/30/2019] [Indexed: 12/21/2022] Open
Abstract
Anxiety is prevalent in asthma, and is associated with disease severity and poor quality of life. However, no study to date provides direct experimental evidence for the effect of allergic inflammation on the structure and function of medial prefrontal cortex (mPFC) and amygdala, which are essential regions for modulating anxiety and its behavioral expression. We assessed the impact of ovalbumin (OVA)-induced allergic inflammation on the appearance of anxiety-like behavior, mPFC and amygdala volumes using MRI, and the mPFC-amygdala circuit activity in sensitized rats. Our findings exhibited that the OVA challenge in sensitized rats induced anxiety-like behavior, and led to more activated microglia and astrocytes in the mPFC and amygdala. We also found a negative correlation between anxiety-like behavior and amygdala volume. Moreover, OVA challenge in sensitized rats was associated with increases in mPFC and amygdala activity, elevation of amygdala delta-gamma coupling, and the enhancement of functional connectivity within mPFC-amygdala circuit – accompanied by an inverted direction of information transferred from the amygdala to the mPFC. We indicated that disrupting the dynamic interactions of the mPFC-amygdala circuit may contribute to the induction of anxiety-related behaviors with asthma. These findings could provide new insight to clarify the underlying mechanisms of allergic inflammation-induced psychiatric disorders related to asthma.
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Affiliation(s)
- Kolsoum Dehdar
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Shirin Mahdidoust
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Morteza Salimi
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Leila Gholami-Mahtaj
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Milad Nazari
- Faculty of Electrical Engineering, Sharif University of Technology, Tehran, Iran
| | - Sadeq Mohammadi
- School of ECE, College of Engineering, University of Tehran, Tehran, Iran
| | - Samaneh Dehghan
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Hamidreza Jamaati
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Khosrowabadi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Abbas Nasiraei-Moghaddam
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Victoria Barkley
- Krembil Research Institute, University Health Network, Toronto, Canada
| | - Mohammad Javan
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.,Department of Brain Sciences and Cognition, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Javad Mirnajafi-Zadeh
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.,Institute for Brain Sciences and Cognition, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Akira Sumiyoshi
- Department of Functional Brain Imaging, IDAC, Tohoku University, Sendai, Japan.,National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Maryland, United States of America
| | - Mohammad Reza Raoufy
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Pagaduan J, Wu SSX, Kameneva T, Lambert E. Acute effects of resonance frequency breathing on cardiovascular regulation. Physiol Rep 2019; 7:e14295. [PMID: 31782265 PMCID: PMC6882954 DOI: 10.14814/phy2.14295] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Acute slow breathing may have beneficial effects on cardiovascular regulation by affecting hemodynamics and the autonomic nervous system. Whether breathing at the resonance frequency (RF), a breathing rate that maximizes heart rate oscillations, induces differential effects to that of slow breathing is unknown. We compared the acute effects of breathing at either RF and RF + 1 breaths per minute on muscle sympathetic nervous activity (MSNA) and baroreflex function. Ten healthy men underwent MSNA, blood pressure (BP), and heart rate (HR) recordings while breathing for 10 min at their spontaneous breathing (SB) rate followed by 10 min at both RF and RF + 1 randomly assigned and separated by a 10-min recovery. Breathing at either RF or RF + 1 induced similar changes in HR and HR variability, with increased low frequency and decreased high frequency oscillations (p < .001 for both). Both respiration rates decreased MSNA (-5.6 and -7.3 bursts per min for RF and RF + 1 p < .05), with the sympathetic bursts occurring more often during mid-inspiration to early expiration (+57% and + 80%) and longer periods of silence between bursts were seen (p < .05 for RF + 1). Systolic BP was decreased only during RF (-4.6 mmHg, p < .05) but the decrease did not differ to that seen during RF + 1 (-3.1 mmHg). The sympathetic baroreflex function remained unchanged at either breathing rates. The slope of the cardiac baroreflex function was unaltered but the cardiac baroreflex efficiency was improved during both RF and RF + 1. Acute breathing at either RF or RF + 1 has similar hemodynamic and sympatho-inhibitory effects in healthy men.
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Affiliation(s)
- Jeffrey Pagaduan
- School of Health SciencesCollege of Health and MedicineUniversity of TasmaniaTasmaniaAustralia
| | - Sam SX Wu
- School of Health SciencesCollege of Health and MedicineUniversity of TasmaniaTasmaniaAustralia
- School of Health SciencesDepartment of Health and Medical SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
| | - Tatiana Kameneva
- Faculty of Science, Engineering and TechnologySwinburne University of TechnologyHawthornVictoriaAustralia
- Iverson Health Innovation Research InstituteSchool of Health Sciences Faculty of Health, Arts and DesignSwinburne University of TechnologyHawthornVictoriaAustralia
- Department of Biomedical EngineeringUniversity of MelbourneParkvilleAustralia
| | - Elisabeth Lambert
- School of Health SciencesDepartment of Health and Medical SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
- Iverson Health Innovation Research InstituteSchool of Health Sciences Faculty of Health, Arts and DesignSwinburne University of TechnologyHawthornVictoriaAustralia
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