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Niwa S, Fila-Pawłowska K, Van den Bergh O, Rymaszewska J. Respiratory dysfunction in persistent somatic symptoms: A systematic review of observational studies. J Psychosom Res 2024; 181:111607. [PMID: 38388305 DOI: 10.1016/j.jpsychores.2024.111607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE This systematic review aims to analyze the existing literature investigating respiratory functioning in people with Persistent Somatic Symptoms (PSS) compared to healthy controls, to identify patterns of respiratory disturbances by symptom or syndrome, and describe any respiratory outcomes consistent across diagnoses. METHODS A systematic review following PRISMA guidelines was conducted. A comprehensive search was carried out across five databases (PubMed (NCBI), PsycArticles (Ovid), Web of Science (Core Collection), Embase, and Scopus) using two customised search strings for persistent somatic symptoms and objective respiratory parameters. Title/abstract screening and data extraction were carried out independently by two reviewers. The modified Newcastle-Ottawa Scale was used for quality assessment of the studies. Studies investigating baseline respiratory functioning in adult patients with PSS compared to healthy controls, using at least one objective respiratory were included. RESULTS 18 studies met the inclusion criteria for the review, with a pooled sample size of n = 3245. Chronic pain conditions were found to be the most prevalent subset of diagnoses of interest, comprising six of the studies. 10 studies included measures of lung capacity, flow and/or volume, nine studies reported measures of ventilation, and four studies investigated respiratory muscle functioning. 13 of the included studies reported significant differences in at least one objective respiratory measure between groups (at rest). Scores on self-reported measures of dysnpea and breathlessness were higher in patients compared to healthy controls, while objective respiratory outcomes were varied. CONCLUSION The current systematic review is consistent with previous literature suggesting more pronounced experiences of breathlessness in patients with PSS, and significant disparities between reported dyspnea and objective respiratory outcomes. Research investigating the uncoupling between subjective and objective respiratory outcomes is needed to understand the mechanisms behind breathing disturbances in PSS.
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Affiliation(s)
- Saya Niwa
- Department of Biomedical Engineering, Wrocław University of Science and Technology, Poland.
| | | | - Omer Van den Bergh
- Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Belgium.
| | - Joanna Rymaszewska
- Department of Clinical Neuroscience, Wrocław University of Science and Technology, Poland.
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2
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Ritz T. Putting back respiration into respiratory sinus arrhythmia or high-frequency heart rate variability: Implications for interpretation, respiratory rhythmicity, and health. Biol Psychol 2024; 185:108728. [PMID: 38092221 DOI: 10.1016/j.biopsycho.2023.108728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
Research on respiratory sinus arrhythmia, or high-frequency heart rate variability (its frequency-domain equivalent), has been popular in psychology and the behavioral sciences for some time. It is typically interpreted as an indicator of cardiac vagal activity. However, as research has shown for decades, the respiratory pattern can influence the amplitude of these noninvasive measures substantially, without necessarily reflecting changes in tonic cardiac vagal activity. Although changes in respiration are systematically associated with experiential and behavioral states, this potential confound in the interpretation of RSA, or HF-HRV, is rarely considered. Interpretations of within-individual changes in these parameters are therefore only conclusive if undertaken relative to the breathing pattern. The interpretation of absolute levels of these parameters between individuals is additionally burdened with the problem of residual inspiratory cardiac vagal activity in humans. Furthermore, multiple demographic, anthropometric, life-style, health, and medication variables can act as relevant third variables that might explain associations of RSA or HF-HRV with experiential and behavioral variables. Because vagal activity measured by these parameters only represents the portion of cardiac vagal outflow that is modulated by the respiratory rhythm, alternative interpretations beyond cardiac vagal activity should be considered. Accumulating research shows that activity of multiple populations of neurons in the brain and the periphery, and with that organ activity and function, are modulated rhythmically by respiratory activity. Thus, observable health benefits ascribed to the cardiac vagal system through RSA or HF-HRV may actually reflect beneficial effects of respiratory modulation. Respiratory rhythmicity may ultimately provide the mechanism that integrates central, autonomic, and visceral activities.
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Affiliation(s)
- Thomas Ritz
- Department of Psychology, Southern Methodist University, Dallas, TX, USA.
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3
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Fincham GW, Strauss C, Cavanagh K. Effect of coherent breathing on mental health and wellbeing: a randomised placebo-controlled trial. Sci Rep 2023; 13:22141. [PMID: 38092805 PMCID: PMC10719279 DOI: 10.1038/s41598-023-49279-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023] Open
Abstract
Breathwork may offer simple tools for stress resilience. We conducted the largest parallel randomised-controlled trial on breathwork to date (NCT05676658) wherein 400 participants on the research platform Prolific were randomised, in blocks of 2 via remote software, to coherent breathing at ~ 5.5 breaths/min or a matched attention-placebo at 12 breaths/min, for ~ 10 min/day over 4 weeks. Participants were blinded to their allocated interventions, both of which were paced with equal inhalation:exhalation ratios. There were no differences on credibility and expectancy of benefit between conditions. At the primary timepoint post-intervention for the primary outcome subjective stress, there was no significant group by time interaction (F(1,377) = 0.089, p = 0.765, ηp2 < 0.001) nor main effect of group (F = 0.002, p = 0.961, ηp2 < 0.001), however there was a significant main effect of time (F = 72.1, p < 0.001, ηp2 = 0.161). Similar results were found at 1-month follow-up for stress and for secondary outcomes of anxiety, depression and wellbeing. There were overall improvements on these mental health and wellbeing outcomes from baseline to post-intervention and follow-up across both groups, yet the magnitude of this improvement was not different between arms. Accordingly, we found no measurable effect of coherent breathing over and above a well-designed breathwork placebo at improving mental health and wellbeing. Methodological considerations and recommendations for robust future research are discussed. Funder: Sasakawa Young Leaders Fellowship Fund, Tokyo, Japan.
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Affiliation(s)
- Guy W Fincham
- Department of Psychology, University of Sussex, Brighton, UK.
- Brighton & Sussex Medical School, University of Sussex, Brighton, UK.
| | - Clara Strauss
- Department of Psychology, University of Sussex, Brighton, UK
- Research & Development Department, Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - Kate Cavanagh
- Department of Psychology, University of Sussex, Brighton, UK
- Research & Development Department, Sussex Partnership NHS Foundation Trust, Brighton, UK
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Yoo HJ, Nashiro K, Dutt S, Min J, Cho C, Thayer JF, Lehrer P, Chang C, Mather M. Daily biofeedback to modulate heart rate oscillations affects structural volume in hippocampal subregions targeted by the locus coeruleus in older adults but not younger adults. Neurobiol Aging 2023; 132:85-99. [PMID: 37769491 PMCID: PMC10840698 DOI: 10.1016/j.neurobiolaging.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023]
Abstract
Using data from a clinical trial, we tested the hypothesis that daily sessions modulating heart rate oscillations affect older adults' volume of a region-of-interest (ROI) comprised of adjacent hippocampal subregions with relatively strong locus coeruleus (LC) noradrenergic input. Younger and older adults were randomly assigned to one of two daily biofeedback practices for 5 weeks: (1) engage in slow-paced breathing to increase the amplitude of oscillations in heart rate at their breathing frequency (Osc+); (2) engage in self-selected strategies to decrease heart rate oscillations (Osc-). The interventions did not significantly affect younger adults' hippocampal volume. Among older adults, the two conditions affected volume in the LC-targeted hippocampal ROI differentially as reflected in a significant condition × time-point interaction on ROI volume. These condition differences were driven by opposing changes in the two conditions (increased volume in Osc+ and decreased volume in Osc-) and were mediated by the degree of heart rate oscillation during training sessions.
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Affiliation(s)
- Hyun Joo Yoo
- University of Southern California, Los Angeles, CA 90089, USA
| | - Kaoru Nashiro
- University of Southern California, Los Angeles, CA 90089, USA
| | - Shubir Dutt
- University of Southern California, Los Angeles, CA 90089, USA
| | - Jungwon Min
- University of Southern California, Los Angeles, CA 90089, USA
| | - Christine Cho
- University of Southern California, Los Angeles, CA 90089, USA
| | | | - Paul Lehrer
- Rutgers University, New Brunswick, NJ 08852, USA
| | - Catie Chang
- Vanderbilt University, Nashville, TN 37235, USA
| | - Mara Mather
- University of Southern California, Los Angeles, CA 90089, USA.
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5
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Prabhu S, Nayak K, Kadiyali A, Devasia T, Varadaraju R, Moodukudru M. Physical and psychological impact of yoga therapy in improving heart failure. Trop Doct 2023; 53:455-459. [PMID: 37321800 DOI: 10.1177/00494755231180633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Effective therapy for patients with chronic cardiac failure (CCF) entails significant lifestyle modifications as well as often complex pharmaceutical regimes to alleviate symptoms, which, however, do not actually cure many patients. The gradual loss of cardiac function is impeded but not halted by such complicated pharmacological therapy, which primarily includes angiotensin-converting enzyme inhibitors, beta-blockers and diuretics, and sometimes digoxin, aspirin, warfarin, and anti-arrhythmic agents. Patients may be advised to track their weight and modify their diuretic prescription accordingly to avoid fluid overload or dehydration as part of the treatment plan. Non-pharmacologic treatment options are routinely integrated to improve the management of somatic complaints. Yoga and specialized breathing exercises seem to help CCF patients improve their cardiorespiratory and autonomic system function, and also their quality of life. We present the evidence.
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Affiliation(s)
- Sridevi Prabhu
- Department of Cardiovascular Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Krishnananda Nayak
- Department of Cardiovascular Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Annapoorna Kadiyali
- Division of Yoga, Centre for Integrative Medicine and Research, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Tom Devasia
- Department of Cardiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rekha Varadaraju
- Department of Cardiovascular Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Manjoosha Moodukudru
- Department of Cardiovascular Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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6
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Trivedi GY, Kathirvel S, Sharma K, Saboo B. Effect of Various Lengths of Respiration on Heart Rate Variability during Simple Bhramari (Humming). Int J Yoga 2023; 16:123-131. [PMID: 38204770 PMCID: PMC10775838 DOI: 10.4103/ijoy.ijoy_113_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 01/12/2024] Open
Abstract
Background Heart rate varies during breathing and the heart rate variability (HRV) facilitates the autonomic homeostatic capacity. The maximum HRV was observed at around 10 s of prolonged respiration as per HRV biofeedback literature. However, there is a gap in understanding the variations in HRV by different respiration lengths during simple Bhramari practice. Objective To assess the effect of various respiration lengths (8, 10, 12, and 14 s) on HRV during the simple Bhramari (humming) practice. Methodology A total of 118 individuals (67 males, 51 females) signed up for the study based on convenience sampling at a wellness center. A randomized (simple permutation) within-subject crossover design with repeated measures was used to measure their HRV during the simple Bhramari practice. The results were analyzed with one-way ANOVA and paired samples t-test. Results The results indicate that, unlike the 10 s of respiration during HRV biofeedback breathing, maximum HRV during humming happens between 12 and 14 s of long breathing. Conclusions The unique findings of the study demonstrate the maximization of HRV between the respiration lengths of 12 and 14 s. Future work should explore expanding the research to a broader group of participants, including individuals with chronic conditions and other demographic variables and mantra chanting.
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Affiliation(s)
- Gunjan Y. Trivedi
- Co-founder, Society for Energy and Emotions, Wellness Space, Ahmedabad, Gujarat, India
| | - Soundappan Kathirvel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kamal Sharma
- Chief of Interventional Cardiology, SAL Hospital, Ahmedabad, Gujarat, India
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7
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Tian QQ, Cheng C, Liu PH, Yin ZX, Zhang MK, Cui YP, Zhao R, Deng H, Lu LM, Tang CZ, Xu NG, Yang XJ, Sun JB, Qin W. Combined effect of transcutaneous auricular vagus nerve stimulation and 0.1 Hz slow-paced breathing on working memory. Front Neurosci 2023; 17:1133964. [PMID: 36968483 PMCID: PMC10034029 DOI: 10.3389/fnins.2023.1133964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundPrevious research has found that transcutaneous auricular vagus nerve stimulation (taVNS) can improve working memory (WM) performance. It has also been shown that 0.1 Hz slow-paced breathing (SPB, i.e., breathing at a rate of approximately 6 breaths/min) can significantly influence physical state and cognitive function via changes in autonomic afferent activity. In the present study, we investigated the synergistic effects of taVNS and SPB on WM performance.MethodsA total of 96 healthy people participated in this within-subjects experiment involving four conditions, namely taVNS, SPB, combined taVNS with SPB (taVNS + SPB), and sham. Each participant underwent each intervention for 30 min and WM was compared pre- and post-intervention using the spatial and digit n-back tasks in a random order four times. Permutation-based analysis of variance was used to assess the interaction between time and intervention.ResultsFor the spatial 3-back task, a significant interaction between time and intervention was found for the accuracy rate of matching trials (mACC, p = 0.03). Post hoc analysis suggested that both taVNS and taVNS + SPB improved WM performance, however, no significant difference was found in the SPB or sham groups.ConclusionThis study has replicated the effects of taVNS on WM performance reported in previous studies. However, the synergistic effects of combined taVNS and SPB warrant further research.
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Affiliation(s)
- Qian-Qian Tian
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Chen Cheng
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Peng-Hui Liu
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Zi-Xin Yin
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Meng-Kai Zhang
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Ya-Peng Cui
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Rui Zhao
- School of Electronics and Information, Xi’an Polytechnic University, Xi’an, Shaanxi, China
| | - Hui Deng
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
- Guangzhou Institute of Technology, Xidian University, Xi’an, Shaanxi, China
| | - Li-Ming Lu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chun-Zhi Tang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Neng-Gui Xu
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xue-Juan Yang
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
- Guangzhou Institute of Technology, Xidian University, Xi’an, Shaanxi, China
- Xue-Juan Yang,
| | - Jin-Bo Sun
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
- Guangzhou Institute of Technology, Xidian University, Xi’an, Shaanxi, China
- *Correspondence: Jin-Bo Sun,
| | - Wei Qin
- Intelligent Non-Invasive Neuromodulation Technology and Transformation Joint Laboratory, Xidian University, Xi’an, Shaanxi, China
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China
- Guangzhou Institute of Technology, Xidian University, Xi’an, Shaanxi, China
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Nashiro K, Min J, Yoo HJ, Cho C, Bachman SL, Dutt S, Thayer JF, Lehrer PM, Feng T, Mercer N, Nasseri P, Wang D, Chang C, Marmarelis VZ, Narayanan S, Nation DA, Mather M. Increasing coordination and responsivity of emotion-related brain regions with a heart rate variability biofeedback randomized trial. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:66-83. [PMID: 36109422 PMCID: PMC9931635 DOI: 10.3758/s13415-022-01032-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 12/15/2022]
Abstract
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 functional connectivity in emotion-related resting-state networks during rest. It also increased down-regulation of activity in somatosensory brain regions during an emotion regulation task. The Osc- intervention did not have these effects. In this healthy cohort, the two conditions did not differentially affect anxiety, depression, or mood. These findings indicate that modulating heart rate oscillatory activity changes emotion network coordination in the brain.
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Affiliation(s)
- Kaoru Nashiro
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Jungwon Min
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Hyun Joo Yoo
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Christine Cho
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Shelby L Bachman
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Shubir Dutt
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | | | | | - Tiantian Feng
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Noah Mercer
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Padideh Nasseri
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Diana Wang
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | | | - Vasilis Z Marmarelis
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Shri Narayanan
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | | | - Mara Mather
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA.
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9
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Mengden T, Bachler M, Sehnert W, Marschall P, Wassertheurer S. Device-guided slow breathing with direct biofeedback of pulse wave velocity - acute effects on pulse arrival time and self-measured blood pressure. Blood Press Monit 2023; 28:52-58. [PMID: 36606480 PMCID: PMC9815813 DOI: 10.1097/mbp.0000000000000628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/23/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND There isevidence that device-guided slow breathing using biofeedback acutely reduces blood pressure (BP) and pulse wave velocity [i.e. increased pulse arrival time (PAT)]. OBJECTIVES The objectives of the study presented here were to test whether the results of changes observed in PAT in earlier studies are reproducible over 1 week and how changes in pulse wave velocity/PAT translate into absolute self-measured BP changes. METHODS Patients with a systolic BP 130-160 mmHg or treated essential hypertension (21 females/23 males) were trained to perform unattended device-guided slow breathing exercises for 10 min daily over 5 days. Furthermore, they were skilled to perform self-measurement of BP before and after the breathing exercise using a validated upper-arm device. RESULTS Office BP at screening [median (1, 3. Q)] was 137 (132, 142)/83 (79, 87) mmHg. We observed a significant ( P < 0.05) increase in PAT of 5 ms (SD 12.5 ms) on average after 10 min of guided breathing and an additional 1 ms ( P < 0.05, SD 8 ms) during the following 5 min of spontaneous breathing compared to baseline. PAT before the exercise remained constant over 5 days paralleled by constant self-measured BP before the exercise. Device-guided breathing was associated with a significant reduction of self-measured SBP of 5 mmHg ( P < 0.01, SD 8 mmHg). Data furthermore demonstrated that these changes were highly reproducible over 1 week. CONCLUSIONS Device-guided slow breathing and biofeedback lead to reproducible and favorable changes (increase) in PAT and SBP (decrease).
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Affiliation(s)
- Thomas Mengden
- Kerckhoff Clinic, ESH Excellence Centre, Bad Nauheim, Germany
| | - Martin Bachler
- Medical Signal Analysis, AIT Austrian Institute of Technology, Center for Health and Bioresources, Vienna, Austria
| | - Walter Sehnert
- Institute for Clinical Research Sehnert, Dortmund, Germany
| | | | - Siegfried Wassertheurer
- Medical Signal Analysis, AIT Austrian Institute of Technology, Center for Health and Bioresources, Vienna, Austria
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10
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Pagani E, Gavazzoni N, Bernardelli G, Malacarne M, Solaro N, Giusti E, Castelnuovo G, Volpi P, Carimati G, Lucini D. Psychological Intervention Based on Mental Relaxation to Manage Stress in Female Junior Elite Soccer Team: Improvement in Cardiac Autonomic Control, Perception of Stress and Overall Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:942. [PMID: 36673698 PMCID: PMC9859004 DOI: 10.3390/ijerph20020942] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
Chronic stress may represent one of the most important factors that negatively affects the health and performance of athletes. Finding a way to introduce psychological strategies to manage stress in everyday training routines is challenging, particularly in junior teams. We also must consider that a stress management intervention should be regarded as "efficacious" only if its application results in improvement of the complex underlying pathogenetic substratum, which considers mechanistically interrelated factors, such as immunological, endocrine and autonomic controls further to psychological functioning and behavior. In this study, we investigated the feasibility of implementing, in a standard training routine of the junior team of the Italian major soccer league, a stress management program based on mental relaxation training (MRT). We evaluated its effects on stress perception and cardiac autonomic regulation as assessed by means of ANSI, a single composite percentile-ranked proxy of autonomic balance, which is free of gender and age bias, economical, and simple to apply in a clinical setting. We observed that the simple employed MRT intervention was feasible in a female junior soccer team and was associated with a reduced perception of stress, an improved perception of overall health, and a betterment of cardiac autonomic control. This data may corroborate the scientific literature that indicates psychological intervention based on MRT as an efficacious strategy to improve performance, managing negative stress effects on cardiac autonomic control.
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Affiliation(s)
- Eleonora Pagani
- Department of General Psychology, Catholic University, 20123 Milan, Italy
| | | | - Giuseppina Bernardelli
- DISCCO Department, University of Milan, 20122 Milan, Italy
- Exercise Medicine Unit, Istituto Auxologico Italiano, IRCCS, 20135 Milan, Italy
| | - Mara Malacarne
- BIOMETRA Department, University of Milan, 20129 Milan, Italy
| | - Nadia Solaro
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
| | - Emanuele Giusti
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, 20149 Milan, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University, 20123 Milan, Italy
- Clinical Psychology Research laboratory, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy
| | - Piero Volpi
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | | | - Daniela Lucini
- Exercise Medicine Unit, Istituto Auxologico Italiano, IRCCS, 20135 Milan, Italy
- BIOMETRA Department, University of Milan, 20129 Milan, Italy
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11
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Nashiro K, Yoo HJ, Min J, Cho C, Nasseri P, Zhang Y, Lehrer P, Thayer JF, Mather M. Effects of a randomised trial of 5-week heart rate variability biofeedback intervention on mind wandering and associated brain function. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2022; 22:1349-1357. [PMID: 35761030 PMCID: PMC11226233 DOI: 10.3758/s13415-022-01019-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 01/27/2023]
Abstract
Previous research suggests that excessive negative self-related thought during mind wandering involves the default mode network (DMN) core subsystem and the orbitofrontal cortex (OFC). Heart rate variability (HRV) biofeedback, which involves slow paced breathing to increase HRV, is known to promote emotional well-being. However, it remains unclear whether it has positive effects on mind wandering and associated brain function. We conducted a study where young adults were randomly assigned to one of two 5-week interventions involving daily biofeedback that either increased heart rate oscillations via slow paced breathing (Osc+ condition) or had little effect on heart rate oscillations (active control or Osc- condition). The two intervention conditions did not differentially affect mind wandering and DMN core-OFC functional connectivity. However, the magnitude of participants' heart rate oscillations during daily biofeedback practice was associated with pre-to-post decreases in mind wandering and in DMN core-OFC functional connectivity. Furthermore, the reduction in the DMN core-OFC connectivity was associated with a decrease in mind wandering. Our results suggested that daily sessions involving high amplitude heart rate oscillations may help reduce negative mind wandering and associated brain function.
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How Chanting Relates to Cognitive Function, Altered States and Quality of Life. Brain Sci 2022; 12:brainsci12111456. [DOI: 10.3390/brainsci12111456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022] Open
Abstract
Chanting is practiced in many religious and secular traditions and involves rhythmic vocalization or mental repetition of a sound or phrase. This study examined how chanting relates to cognitive function, altered states, and quality of life across a wide range of traditions. A global survey was used to assess experiences during chanting including flow states, mystical experiences, mindfulness, and mind wandering. Further, attributes of chanting were assessed to determine their association with altered states and cognitive benefits, and whether psychological correlates of chanting are associated with quality of life. Responses were analyzed from 456 English speaking participants who regularly chant across 32 countries and various chanting traditions. Results revealed that different aspects of chanting were associated with distinctive experiential outcomes. Stronger intentionality (devotion, intention, sound) and higher chanting engagement (experience, practice duration, regularity) were associated with altered states and cognitive benefits. Participants whose main practice was call and response chanting reported higher scores of mystical experiences. Participants whose main practice was repetitive prayer reported lower mind wandering. Lastly, intentionality and engagement were associated with quality of life indirectly through altered states and cognitive benefits. This research sheds new light on the phenomenology and psychological consequences of chanting across a range of practices and traditions.
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Autonomic functions, tinnitus annoyance and loudness, and quality of life: Randomized-controlled responses to bee-humming (vibrational) respiratory training in tinnitus elderly. Complement Ther Clin Pract 2022; 48:101611. [DOI: 10.1016/j.ctcp.2022.101611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/07/2022] [Accepted: 05/29/2022] [Indexed: 11/23/2022]
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The Psychophysiological Profile and Cardiac Autonomic Reactivity in Long-Term Female Yoga Practitioners: A Comparison with Runners and Sedentary Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137671. [PMID: 35805328 PMCID: PMC9266125 DOI: 10.3390/ijerph19137671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
Abstract
Yoga practice, a means of stress management, has been reported to optimize psychophysiological health; however, its underlying mechanisms remain unclear. The purpose of the present study was to examine the psychophysiological profile and cardiac autonomic reactivity in long-term yoga practitioners and compare them to runners and sedentary individuals. Psychological health and aerobic fitness level were evaluated using self-reported questionnaires and a 3-min step test. Blood pressure (BP), heart rate (HR), respiration rate (RR), and heart rate variability (HRV) parameters were recorded at rest, as well as during and following psychological stress, which was elicited by the Stroop color and word test and the mental arithmetic task. The yoga group demonstrated a lower RR (10.35 ± 2.13 bpm) as compared to the other two groups, and a lower HR (66.60 ± 7.55 bpm) and diastolic BP (67.75 ± 8.38 mmHg) at rest when compared to the sedentary group (all p < 0.05). HRV parameters following mental stress returned to the baseline in yoga and running groups, but not in the sedentary group. The anxiety level in the running group was significantly lower than that in the sedentary group (p < 0.05). These findings suggested that yoga practitioners may have a greater homeostatic capacity and autonomic resilience than do sedentary individuals.
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Hotho G, von Bonin D, Krüerke D, Wolf U, Cysarz D. Unexpected Cardiovascular Oscillations at 0.1 Hz During Slow Speech Guided Breathing (OM Chanting) at 0.05 Hz. Front Physiol 2022; 13:875583. [PMID: 35620613 PMCID: PMC9127736 DOI: 10.3389/fphys.2022.875583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Slow breathing at 0.1 Hz (i.e., 6 cycles per minute, cpm) leads to strong cardiovascular oscillations. However, the impact of breathing below 6 cpm is rarely addressed. We investigated the influence of OM chanting, an ancient Indian mantra, with approx. 3 respiratory cpm (0.05 Hz) on the synchronisation of heart period (RR), respiration (RESP) and systolic blood pressure (SBP). Nine healthy, trained speech practitioners chanted three sequences of five subsequent OM with 2 min pauses in between. Each single OM chanting consisted of taking a deep breath and a long “OM” during expiration and lasted approx. 20 s. ECG, respiration and blood pressure were recorded continuously, of which the RR tachogram, RESP and SBP were derived. Synchronisation between the signals was computed using the phase difference between two signals. During OM chanting synchronisation among the oscillations of RR, SBP and RESP was significantly increased compared to rest. Furthermore, OM chanting at breathing frequencies between 0.046 and 0.057 Hz resulted in 0.1 Hz oscillations in RR and SBP. In conclusion, OM chanting strongly synchronized cardiorespiratory and blood pressure oscillations. Unexpected oscillations at 0.1 Hz in SBP and RR appear at breathing frequencies of approx. 0.05 Hz. Such frequency doubling may originate from an interaction of breathing frequency with endogenous Mayer waves.
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Affiliation(s)
- Gerard Hotho
- Biologisch Onderzoek Gennep, Eindhoven, Netherland
- Research Department, Clinic Arlesheim, Arlesheim, Switzerland
| | - Dietrich von Bonin
- Group Practice Therapeutikum, Bern, Switzerland
- Institute of Complementary and Integrative Medicine, University of Bern, Bern, Switzerlamd
| | - Daniel Krüerke
- Research Department, Clinic Arlesheim, Arlesheim, Switzerland
| | - Ursula Wolf
- Institute of Complementary and Integrative Medicine, University of Bern, Bern, Switzerlamd
| | - Dirk Cysarz
- Integrated Curriculum for Anthroposophic Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
- *Correspondence: Dirk Cysarz,
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Naderi M, Kordestani H, Sahebi Z, Khedmati Zare V, Amani-Shalamzari S, Kaviani M, Wiskemann J, Molanouri Shamsi M. Serum and gene expression profile of cytokines following combination of yoga training and vitamin D supplementation in breast cancer survivors: a randomized controlled trial. BMC Womens Health 2022; 22:90. [PMID: 35331230 PMCID: PMC8952887 DOI: 10.1186/s12905-022-01671-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/17/2022] [Indexed: 01/21/2023] Open
Abstract
Background This study aimed to examine the effect of the combination of yoga training with high vitamin D dose supplementation on the expression and systemic levels of inflammatory cytokines and psychophysical status of breast cancer survivors. Methods Thirty volunteered breast cancer survivors (48 ± 8 years) were randomly allocated to a high dose (4000 IU) of vitamin D supplementation (HD) group (n = 10), yoga with a high dose of vitamin D (YHD) group (n = 10), and yoga with a low dose (2000 IU) of vitamin D (YLD) group (n = 10). Participants performed the Hatha yoga style for 12 weeks, twice a week. Blood samples, quality of life (QoL) questionnaire, and physical performance tests were taken before and after the intervention. Results Body fat percentage (ηp2 = 0.36), handgrip strength (ηp2 = 0.41) and QoL indicators include global health (ηp2 = 0.54), functional scales (ηp2 = 0.49), and symptoms scales (ηp2 = 0.50) were significantly improved in the both YHD and YLD groups compared to the HD group (p < 0.05). Also, interleukin-10 (IL-10) levels were markedly increased in the Y-HVD group compared to the Y-LVD and HVD groups. Moreover, there were significant decreases in tumor necrosis factor-α (TNF-α) and interleukin-6 levels in the Y-HVD group after the intervention. The anti-inflammatory index (IL-10/TNF-α) was significantly increased in both the yoga groups (P < 0.05). Conclusion Yoga promotes physical and psychological fitness and, in combination with a high dose of vitamin D, improves the cytokine profile, which can effectively manage the side effects associated with cancer. Trial registration IRCT20210726051993N2. Registration date: 2022/02/27. URL: https://www.irct.ir/trial/62079
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Affiliation(s)
- Mahdi Naderi
- Departement of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Hajar Kordestani
- Departement of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Zahra Sahebi
- Departement of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Vahid Khedmati Zare
- Departement of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Sadegh Amani-Shalamzari
- Department of Exercise Physiology, Faculty of Physical Education and Sports Science, Kharazmi University, Tehran, Iran.
| | - Mojtaba Kaviani
- School of Nutrition and Dietetics, Faculty of Pure and Applied Science, Acadia University, Wolfville, NS, Canada
| | - Joachim Wiskemann
- Working Group Exercise Oncology, Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany
| | - Mahdieh Molanouri Shamsi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
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Ginsberg JP, Raghunathan K, Bassi G, Ulloa L. Review of Perioperative Music Medicine: Mechanisms of Pain and Stress Reduction Around Surgery. Front Med (Lausanne) 2022; 9:821022. [PMID: 35187004 PMCID: PMC8854756 DOI: 10.3389/fmed.2022.821022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/12/2022] [Indexed: 12/19/2022] Open
Abstract
Clinical-experimental considerations and an approach to understanding the autonomic basis of improved surgical outcomes using Perioperative Music Medicine (PMM) are reviewed. Combined surgical, psycho-physiological, and experimental perspectives on Music Medicine (MM) and its relationship to autonomic nervous system (ANS) function are discussed. Considerations are given to the inter-related perioperative effects of MM on ANS, pain, and underlying vagal and other neural circuits involved in emotional regulation and dysregulation. Many surgical procedures are associated with significant pain, which is routinely treated with post-operative opioid medications, which cause detrimental side effects and delay recovery. Surgical trauma shifts the sympathetic ANS to a sustained activation impairing physiological homeostasis and causing psychological stress, as well as metabolic and immune dysfunction that contribute to postoperative mortality and morbidity. In this article, we propose a plan to operationalize the study of mechanisms mediating the effects of MM in perioperative settings of orthopedic surgery. These studies will be critical for the implementation of PMM as a routine clinical practice and to determine the potential limitations of MM in specific cohorts of patients and how to improve the treatment.
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Affiliation(s)
- J. P. Ginsberg
- Departments of Applied Psychophysiology, Psychology and Statistics, Saybrook University, Pasadena, CA, United States
| | - Karthik Raghunathan
- Critical Care and Perioperative Population Health Research Unit, Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
| | - Gabriel Bassi
- Department of Anesthesiology, Center for Perioperative Organ Protection, Duke University Medical Center, Durham, NC, United States
| | - Luis Ulloa
- Department of Anesthesiology, Center for Perioperative Organ Protection, Duke University Medical Center, Durham, NC, United States
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Mangala Gowri M, Rajendran J, Srinivasan AR, Bhavanani AB, Meena R. Impact of an Integrated Yoga Therapy Protocol on Insulin Resistance and Glycemic Control in Patients with Type 2 Diabetes Mellitus. Rambam Maimonides Med J 2022; 13:RMMJ.10462. [PMID: 35089124 PMCID: PMC8798588 DOI: 10.5041/rmmj.10462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Diabetes mellitus (DM), characterized by chronic hyperglycemia, is attributed to relative insulin deficiency or resistance, or both. Studies have shown that yoga can modulate parameters of insulin resistance. The present study explored the possible beneficial effects of integrated yoga therapy with reference to glycemic control and insulin resistance (IR) in individuals with diabetes maintained on standard oral medical care with yoga therapy, compared to those on standard oral medical care alone. METHODS In this study, the subjects on yoga intervention comprised 35 type 2 diabetics, and an equal number of volunteers constituted the control group. Subjects ranged in age from 30 to 70 years, with hemoglobin A1c (HbA1c) test more than 7%, and were maintained on diabetic diet and oral hypoglycemic agents. Blood samples were drawn prior to and after 120 days of integrated yoga therapy intervention. Fasting blood glucose (FBG), post-prandial blood glucose (PPBG), HbA1c, insulin, and lipid profile were assessed in both the intervention and control groups. RESULTS The intervention group revealed significant improvements in body mass index (BMI) (0.7 kg/m2 median decrease; P=0.001), FBG (20 mg/dL median decrease; P<0.001), PPBG (33 mg/dL median decrease; P<0.001), HbA1c (0.4% median decrease; P<0.001), homeostatic model assessment for insulin resistance (HOMA-IR) (1.2 median decrease; P<0.001), cholesterol (13 mg/dL median decrease, P=0.006), triacylglycerol (22 mg/dL median decrease; P=0.027), low-density lipoprotein (6 mg/dL median decrease; P=0.004), and very-low-density lipoprotein levels (4 mg/dL median decrease; P=0.032). Increases in high-density lipoprotein after 120 days were not significant (6 mg/dL median increase; P=0.15). However, when compared to changes observed in patients in the control group, all these improvements proved to be significant. CONCLUSION Administration of integrated yoga therapy to individuals with diabetes leads to a significant improvement in glycemic control, insulin resistance, and key biochemical parameters.
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Affiliation(s)
- Manoharan Mangala Gowri
- Department of Biochemistry, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (SBV), SBV Campus, Pillaiyarkuppam, Pondicherry, India
| | - Jayanthi Rajendran
- Department of Biochemistry, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (SBV), SBV Campus, Pillaiyarkuppam, Pondicherry, India
| | - Abu Raghavan Srinivasan
- Department of Biochemistry, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (SBV), SBV Campus, Pillaiyarkuppam, Pondicherry, India
- To whom correspondence should be addressed. E-mail:
| | - Ananda Balayogi Bhavanani
- Centre for Yoga Therapy Education and Research, Sri Balaji Vidyapeeth (SBV), SBV Campus, Pillaiyarkuppam, Pondicherry, India
| | - Ramanathan Meena
- Centre for Yoga Therapy Education and Research, Sri Balaji Vidyapeeth (SBV), SBV Campus, Pillaiyarkuppam, Pondicherry, India
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Inbaraj G, Rao RM, Ram A, Bayari SK, Belur S, Prathyusha PV, Sathyaprabha TN, Udupa K. Immediate Effects of OM Chanting on Heart Rate Variability Measures Compared Between Experienced and Inexperienced Yoga Practitioners. Int J Yoga 2022; 15:52-58. [PMID: 35444369 PMCID: PMC9015091 DOI: 10.4103/ijoy.ijoy_141_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/27/2021] [Accepted: 12/30/2021] [Indexed: 11/04/2022] Open
Abstract
Background Chanting "OM" is a form of meditation that has numerous health benefits. However, the neurophysiological mechanisms underpinning its effect are surprisingly scarce. The present study aimed to investigate the effect of OM chanting on autonomic modulation, using heart rate variability (HRV), on experienced yoga practitioners and yoga naïve persons. Methods This prospective study included 19 yoga practitioners (9 females and 10 males; group mean age ± standard deviation [SD]; 25.9 ± 3.2 years) and 17 yoga naïve persons (8 females and 9 males; group mean age ± SD; 24.8 ± 3.6 years) of both sexes and similar age range. Both the groups were assessed for HRV indices (time and frequency domain measures) before and after loud OM chanting for 5 min. Results Baseline comparison using Mann-Whitney U test between groups showed yoga practitioners had significantly increased high frequency (HF) power (P < 0.029) than nonyoga practitioners, signifying a state of tranquility before the chanting of OM. After 5 min of loud chanting of OM, a comparison between groups assessed using Wilcoxon Signed Ranks test revealed: HF Power, a component of the parasympathetic nervous system, was further amplified with a significantly increase (P < 0.001) in the yoga practitioners group compared to nonyoga practitioners. Furthermore, this increase in HF power was positively correlated with the years of experience in yoga. Conclusion The present study showed that a brief chanting of OM (5 min) might enhance parasympathetic nervous system activity, promote relaxation, and provide calmness. Further, this experience may be achieved effectively in individuals experienced in yoga than nonyoga practitioners.
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Affiliation(s)
- Ganagarajan Inbaraj
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Raghvendra M Rao
- Director, Central Council for Research in Yoga and Naturopathy, New Delhi, India
| | - Amritanshu Ram
- Department of Complementary and Alternative Medicine, Health Care Global, Bengaluru, Karnataka, India
| | - Sapna K. Bayari
- Department of Complementary and Alternative Medicine, Health Care Global, Bengaluru, Karnataka, India
| | - Spoorthi Belur
- Department of Complementary and Alternative Medicine, Health Care Global, Bengaluru, Karnataka, India
| | - PV Prathyusha
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - T. N. Sathyaprabha
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Kaviraja Udupa
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India,Address for correspondence: Dr. Kaviraja Udupa, Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru - 560 029, Karnataka, India. E-mail:
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20
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Tseng AA. Scientific Evidence of Health Benefits by Practicing Mantra Meditation: Narrative Review. Int J Yoga 2022; 15:89-95. [PMID: 36329765 PMCID: PMC9623891 DOI: 10.4103/ijoy.ijoy_53_22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 12/04/2022] Open
Abstract
Mantra meditation (MM) is one of the simplest and most effective meditative practices suitable for both novice and skillful meditators. It has attracted a significant number of practitioners for various health benefits or for spiritual inspiration. The scope of this review article focuses on the examination of the health benefits of practicing MM without considering the motivation by spiritual rewarding or cultivation. Through the examination, we attempt to confirm and to add scientific evidence on the benefits of mental and physical health to the practitioners. We review a large number of the recent studies of MM for understanding the mechanism in yielding medical benefits and for analyzing the quantitative evidence of the trial outcomes. The review covers four important areas: stress, anxiety, hypertension, and immunity, with the hope to evoke more studies to refine the current evidence and to encourage more studies in other promising areas. Furthermore, the review gives more attention or discussion on more recent, original, and stronger studies. The discussion can include the strong or weak points of the reviewed studies. The review discovers evidence that MM can provide various degrees of beneficial effects on the four areas considered. Studies with larger participants, superior quality, and a few others are recommended to draw firm conclusions. Several promising research areas and directions are also suggested.
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Affiliation(s)
- Ampere A. Tseng
- Director and Professor Emeritus, Manufacturing Institute, Arizona State University, Tempe, Arizona, USA,Address for correspondence: Prof. Ampere A. Tseng, Arizona State University, ECG301, Tempe, Arizona 85287, USA. E-mail:
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21
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Tanzmeister S, Rominger C, Weber B, Tatschl JM, Schwerdtfeger AR. Singing at 0.1 Hz as a Resonance Frequency Intervention to Reduce Cardiovascular Stress Reactivity? Front Psychiatry 2022; 13:876344. [PMID: 35573368 PMCID: PMC9091602 DOI: 10.3389/fpsyt.2022.876344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Slow breathing at 6 breaths per min (corresponding to ~ 0.1 Hz) has been found to benefit psychological and physical health. In this study, we aimed to examine if paced singing at 0.1 Hz has beneficial acute effects on physiological function as compared to slow breathing. Participants were randomized to one of four experimental interventions prior to performing a mental stress task: paced breathing at 0.1 Hz (n = 26), paced singing at 0.1 Hz (n = 26), spontaneous breathing (n = 24), or spontaneous singing (n = 25). Heart rate, heart rate variability in the low (LF-HRV) and high frequency (HF-HRV) domain, blood pressure and affective wellbeing were assessed. As expected, both paced breathing and paced singing resulted in elevated LF-HRV. Moreover, both singing groups evidenced increases in heart rate, blood pressure and positive affect, thus indicating elevated sympathetic activation. Breathing and singing at 0.1 Hz had no robust effect on cardiovascular stress reactivity. Findings suggest that paced singing could constitute a promising alternative to slow paced breathing as it increases cardiovascular coherence, although more studies are needed to elucidate whether slow breathing and/or singing could ameliorate acute stress responses.
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Affiliation(s)
| | | | - Bernhard Weber
- Institute of Psychology, University of Graz, Graz, Austria
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22
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Tanner V, Faiss R, Saugy J, Bourdillon N, Schmitt L, Millet GP. Similar Supine Heart Rate Variability Changes During 24-h Exposure to Normobaric vs. Hypobaric Hypoxia. Front Neurosci 2021; 15:777800. [PMID: 34955728 PMCID: PMC8695977 DOI: 10.3389/fnins.2021.777800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/22/2021] [Indexed: 01/22/2023] Open
Abstract
Purpose: This study aimed to investigate the differences between normobaric (NH) and hypobaric hypoxia (HH) on supine heart rate variability (HRV) during a 24-h exposure. We hypothesized a greater decrease in parasympathetic-related parameters in HH than in NH. Methods: A pooling of original data from forty-one healthy lowland trained men was analyzed. They were exposed to altitude either in NH (FIO2 = 15.7 ± 2.0%; PB = 698 ± 25 mmHg) or HH (FIO2 = 20.9%; PB = 534 ± 42 mmHg) in a randomized order. Pulse oximeter oxygen saturation (SpO2), heart rate (HR), and supine HRV were measured during a 7-min rest period three times: before (in normobaric normoxia, NN), after 12 (H12), and 24 h (H24) of either NH or HH exposure. HRV parameters were analyzed for time- and frequency-domains. Results: SpO2 was lower in both hypoxic conditions than in NN and was higher in NH than HH at H24. Subjects showed similarly higher HR during both hypoxic conditions than in NN. No difference in HRV parameters was found between NH and HH at any time. The natural logarithm of root mean square of the successive differences (LnRMSSD) and the high frequency spectral power (HF), which reflect parasympathetic activity, decreased similarly in NH and HH when compared to NN. Conclusion: Despite SpO2 differences, changes in supine HRV parameters during 24-h exposure were similar between NH and HH conditions indicating a similar decrease in parasympathetic activity. Therefore, HRV can be analyzed similarly in NH and HH conditions.
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Affiliation(s)
- Valérian Tanner
- Medicine School, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Raphael Faiss
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,REDs, Research and Expertise in Anti-Doping Sciences, University of Lausanne, Lausanne, Switzerland
| | - Jonas Saugy
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,REDs, Research and Expertise in Anti-Doping Sciences, University of Lausanne, Lausanne, Switzerland
| | - Nicolas Bourdillon
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Laurent Schmitt
- National Centre of Nordic-Ski, Research and Performance, Prémanon, France
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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23
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Stöckigt B, Jeserich F, Walach H, Elies M, Brinkhaus B, Teut M. Experiences and Perceived Effects of Rosary Praying: A Qualitative Study. JOURNAL OF RELIGION AND HEALTH 2021; 60:3886-3906. [PMID: 34106378 PMCID: PMC8542536 DOI: 10.1007/s10943-021-01299-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 05/26/2023]
Abstract
The aim of this study is to explore experiences and perceived effects of the Rosary on issues around health and well-being, as well as on spirituality and religiosity. A qualitative study was conducted interviewing ten Roman Catholic German adults who regularly practiced the Rosary prayer. As a result of using a tangible prayer cord and from the rhythmic repetition of prayers, the participants described experiencing stability, peace and a contemplative connection with the Divine, with Mary as a guide and mediator before God. Praying the Rosary was described as helpful in coping with critical life events and in fostering an attitude of acceptance, humbleness and devotion.
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Affiliation(s)
- Barbara Stöckigt
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - F Jeserich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Katholische Akademie "Die Wolfsburg," Bistum Essen, Falkenweg 6, 45478, Mülheim an der Ruhr, Germany
| | - H Walach
- Poznan Medical University, Department Pediatric Gastroenterology, ul. Szpitalna 27/33, 60-572, Poznan, Poland
- Universität Witten-Herdecke, Department Psychologie, Alfred Herrnhausen Str. 50, 58455, Witten, Germany
| | - M Elies
- , Erlenweg 31, 35321, Laubach, Germany
| | - B Brinkhaus
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - M Teut
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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The Gasotransmitter Hydrogen Sulfide and the Neuropeptide Oxytocin as Potential Mediators of Beneficial Cardiovascular Effects through Meditation after Traumatic Events. TRAUMA CARE 2021. [DOI: 10.3390/traumacare1030016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Trauma and its related psychological and somatic consequences are associated with higher cardiovascular morbidity. The regulation of both the gasotransmitter hydrogen sulfide (H2S) and the neuropeptide oxytocin (OT) have been reported to be affected during physical and psychological trauma. Both mediators are likely molecular correlates of trauma-induced cardiovascular complications, because they share parallel roles and signaling pathways in the cardiovascular system, both locally as well as on the level of central regulation and the vagus nerve. Meditation can alter the structure of specific brain regions and can have beneficial effects on cardiovascular health. This perspective article summarizes the evidence pointing toward the significance of H2S and OT signaling in meditation-mediated cardio-protection.
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Raglio A, De Maria B, Perego F, Galizia G, Gallotta M, Imbriani C, Porta A, Dalla Vecchia LA. Effects of Algorithmic Music on the Cardiovascular Neural Control. J Pers Med 2021; 11:jpm11111084. [PMID: 34834436 PMCID: PMC8618683 DOI: 10.3390/jpm11111084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 12/21/2022] Open
Abstract
Music influences many physiological parameters, including some cardiovascular (CV) control indices. The complexity and heterogeneity of musical stimuli, the integrated response within the brain and the limited availability of quantitative methods for non-invasive assessment of the autonomic function are the main reasons for the scarcity of studies about the impact of music on CV control. This study aims to investigate the effects of listening to algorithmic music on the CV regulation of healthy subjects by means of the spectral analysis of heart period, approximated as the time distance between two consecutive R-wave peaks (RR), and systolic arterial pressure (SAP) variability. We studied 10 healthy volunteers (age 39 ± 6 years, 5 females) both while supine (REST) and during passive orthostatism (TILT). Activating and relaxing algorithmic music tracks were used to produce possible contrasting effects. At baseline, the group featured normal indices of CV sympathovagal modulation both at REST and during TILT. Compared to baseline, at REST, listening to both musical stimuli did not affect time and frequency domain markers of both SAP and RR, except for a significant increase in mean RR. A physiological TILT response was maintained while listening to both musical tracks in terms of time and frequency domain markers, compared to baseline, an increase in mean RR was again observed. In healthy subjects featuring a normal CV neural profile at baseline, algorithmic music reduced the heart rate, a potentially favorable effect. The innovative music approach of this study encourages further research, as in the presence of several diseases, such as ischemic heart disease, hypertension, and heart failure, a standardized musical stimulation could play a therapeutic role.
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Affiliation(s)
- Alfredo Raglio
- IRCCS Istituti Clinici Scientifici Maugeri, 27100 Pavia, Italy; (A.R.); (C.I.)
| | - Beatrice De Maria
- IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (B.D.M.); (F.P.); (M.G.)
| | - Francesca Perego
- IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (B.D.M.); (F.P.); (M.G.)
| | | | - Matteo Gallotta
- IRCCS Istituti Clinici Scientifici Maugeri, 20138 Milan, Italy; (B.D.M.); (F.P.); (M.G.)
| | - Chiara Imbriani
- IRCCS Istituti Clinici Scientifici Maugeri, 27100 Pavia, Italy; (A.R.); (C.I.)
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
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Verratti V, Tonacci A, Bondi D, Chiavaroli A, Ferrante C, Brunetti L, Crisafulli A, Cerretelli P. Ethnic Differences on Cardiac Rhythms and Autonomic Nervous System Responses During a High-Altitude Trek: A Pilot Study Comparing Italian Trekkers to Nepalese Porters. Front Physiol 2021; 12:709451. [PMID: 34497537 PMCID: PMC8419438 DOI: 10.3389/fphys.2021.709451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/28/2021] [Indexed: 01/10/2023] Open
Abstract
Altitude hypoxia exposure results in increased sympathetic activity and heart rate due to several mechanisms. Recent studies have contested the validity of heart rate variability (HRV) analysis on sympathetic activity measurement. But the plethora of HRV metrics may provide meaningful insights, particularly if linked with cardiovascular and autonomic nervous system parameters. However, the population-specific nature of HRV and cardiorespiratory response to altitude hypoxia are still missing. Six Italian trekkers and six Nepalese porters completed 300 km of a Himalayan trek. The ECG analysis was conducted at baseline, and before (bBC) and after (aBC) the high-altitude (HA) circuit. Urine was collected before and after the expedition in Italians, for assessing catecholamines. Heart rate increased with altitude significantly (p < 0.001) in the Italian group; systolic (p = 0.030) and diastolic (p = 0.012) blood pressure, and mean arterial pressure (p = 0.004) increased with altitude. Instead, pulse pressure did not change, although the Nepalese group showed lower baseline values than the Italians. As expected, peripheral oxygen saturation decreased with altitude (p < 0.001), independently of the ethnic groups. Nepalese had a higher respiratory rate (p = 0.007), independent of altitude. The cardiac vagal index increased at altitude, from baseline to bBC (p = 0.008). Higuchi fractal dimension (HFD) showed higher basal values in the Nepalese group (p = 0.041), and a tendency for the highest values at bBC. Regarding the urinary catecholamine response, exposure to HA increased urinary levels, particularly of norepinephrine (p = 0.005, d = 1.623). Our findings suggest a better cardiovascular resilience of the Nepalese group when compared with Italians, which might be due to an intrinsic adaptation to HA, resulting from their job.
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Affiliation(s)
- Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Alessandro Tonacci
- Institute of Clinical Physiology, National Research Council of Italy, Pisa, Italy
| | - Danilo Bondi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Annalisa Chiavaroli
- Department of Pharmacy, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Claudio Ferrante
- Department of Pharmacy, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Luigi Brunetti
- Department of Pharmacy, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Antonio Crisafulli
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Paolo Cerretelli
- Institute of Bioimaging and Molecular Physiology, National Research Council of Italy, Segrate, Italy
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Larkey L, Kim W, James D, Kishida M, Vizcaino M, Huberty J, Krishnamurthi N. Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement. Integr Cancer Ther 2021; 19:1534735420949677. [PMID: 32783546 PMCID: PMC7425257 DOI: 10.1177/1534735420949677] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Advancements in early detection and treatment of cancer have led to increased survival rates and greater need to identify effective supportive care options for resolving symptoms of survivorship. Many non-pharmacological approaches to symptom management during and after cancer treatment involve emotional self-regulation as a central strategy for improving well-being. Identifying commonalities among these strategies’ mechanisms of action may facilitate understanding of what might be useful for optimizing intervention effects. Heart rate variability (HRV) parameters are indicative of improved autonomic nervous system (ANS) balance and resiliency and reduced emotional distress and are thus identified as a mechanism to discuss as a marker of potential for intervention efficacy and a target for optimization. Methods: HRV data from 2 studies, 1 examining a mind-body intervention and 1 examining a psychosocial intervention, are presented as a point of discussion about preliminary associations between the interventions, change in HRV, and emotional distress reduction. Results: HRV significantly decreased in sympathetic activity in response to a mind-body intervention (Qigong/Tai Chi), and increased vagal tone in response to a psychosocial (storytelling) intervention. In both, these changes in HRV parameters were associated with improved emotional states. Conclusion: Our preliminary data suggest that HRV may serve as an important marker of underlying changes that mediate emotional regulation; this observation deserves further investigation. If identified as a worthy target, focusing on interventions that improve HRV within the context of interventions for cancer patients may be important to key outcomes and clinical practice.
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Affiliation(s)
- Linda Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Wonsun Kim
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Dara James
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Moé Kishida
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | | | - Jennifer Huberty
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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Trivedi GY, Saboo B. Bhramari Pranayama - A simple lifestyle intervention to reduce heart rate, enhance the lung function and immunity. J Ayurveda Integr Med 2021; 12:562-564. [PMID: 34364739 PMCID: PMC8377171 DOI: 10.1016/j.jaim.2021.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/27/2021] [Accepted: 07/05/2021] [Indexed: 12/04/2022] Open
Abstract
Individuals with chronic diseases have a higher risk of infection and show lung function impairment. Poor lifestyle choices such as physical inactivity, poor diet, stress, excess tobacco, and alcohol, and sleep disruption increase the risk of chronic inflammation and immune impairment but the evidence does not quantify the specific risk factor(s) and their correlation with the immune system impairment. COVID-19 related uncertainty has created a more urgent need to understand the need to identify interventions that could help in managing the risk factors, especially for healthy individuals who are at a higher risk of infection and/or immune system impairment. The role of three parameters, the Resting Heart Rate (HR), increased Heart Rate Variability (HRV), and lung function is considered as risk factors for systemic inflammation and chronic diseases. The evidence on Bhramari Pranayama is presented for possible lifestyle interventions to reduce the risk of infection, increase lung function, enhance autonomic function, and improve sleep quality in healthy individuals.
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Affiliation(s)
- Gunjan Y Trivedi
- Society for Energy & Emotions, Wellness Space, JJT University, India.
| | - Banshi Saboo
- Diabetologist and Chairman, Dia Care, Ahmedabad, India
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Szulczewski MT. Transcutaneous Auricular Vagus Nerve Stimulation Combined With Slow Breathing: Speculations on Potential Applications and Technical Considerations. Neuromodulation 2021; 25:380-394. [PMID: 35396070 DOI: 10.1111/ner.13458] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/02/2021] [Accepted: 04/26/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Transcutaneous auricular vagus nerve stimulation (taVNS) is a relatively novel noninvasive neurostimulation method that is believed to mimic the effects of invasive cervical VNS. It has recently been suggested that the effectiveness of taVNS can be enhanced by combining it with controlled slow breathing. Slow breathing modulates the activity of the vagus nerve and is used in behavioral medicine to decrease psychophysiological arousal. Based on studies that examine the effects of taVNS and slow breathing separately, this article speculates on some of the conditions in which this combination treatment may prove effective. Furthermore, based on findings from studies on the optimization of taVNS and slow breathing, this article provides guidance on how to combine taVNS with slow breathing. MATERIALS AND METHODS A nonsystematic review. RESULTS Both taVNS and slow breathing are considered promising add-on therapeutic approaches for anxiety and depressive disorders, chronic pain, cardiovascular diseases, and insomnia. Therefore, taVNS combined with slow breathing may produce additive or even synergistic beneficial effects in these conditions. Studies on respiratory-gated taVNS during spontaneous breathing suggest that taVNS should be delivered during expiration. Therefore, this article proposes to use taVNS as a breathing pacer to indicate when and for how long to exhale during slow breathing exercises. CONCLUSIONS Combining taVNS with slow breathing seems to be a promising hybrid neurostimulation and behavioral intervention.
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30
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Simpson FM, Perry G, Thompson WF. Assessing Vocal Chanting as an Online Psychosocial Intervention. Front Psychol 2021; 12:647632. [PMID: 34140914 PMCID: PMC8203819 DOI: 10.3389/fpsyg.2021.647632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/30/2021] [Indexed: 01/22/2023] Open
Abstract
The ancient practice of chanting typically takes place within a community as a part of a live ceremony or ritual. Research suggests that chanting leads to improved mood, reduced stress, and increased wellbeing. During the global pandemic, many chanting practices were moved online in order to adhere to social distancing recommendations. However, it is unclear whether the benefits of live chanting occur when practiced in an online format. The present study assessed the effects of a 10-min online chanting session on stress, mood, and connectedness, carried out either in a group or individually. The study employed a 2 (chanting vs. control) × 2 (group vs. individual) between-subjects design. Participants (N = 117) were pseudo-randomly allocated across the four conditions. Before and after participation, individuals completed the Spielberg’s State Trait Anxiety Inventory, the Positive and Negative Affect Schedule, the Social Connectedness Scale and Aron’s Inclusion of Self in Other Scale. Online chanting led to a significant reduction in stress and an increase in positive affect when compared to the online control task. Participants who took part in group chanting also felt more connected to members of their chanting group than participants in the control group. However, feelings of general connectedness to all people remained similar across conditions. The investigation provides evidence that online chanting may be a useful psychosocial intervention, whether practiced individually or in a group.
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Affiliation(s)
- Felicity Maria Simpson
- School of Psychological Sciences, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Gemma Perry
- School of Psychological Sciences, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - William Forde Thompson
- School of Psychological Sciences, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, NSW, Australia
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Lozano Montes L, Balakrishnan V, Gopalakrishnan S. Effects of Integrated Amrita Meditation Technique on Anxiety, Depression, and Plasma Neurotransmitters on a Healthy Population: A Randomized Controlled Trial Followed by a Case-Control Study. J Altern Complement Med 2021; 27:641-648. [PMID: 34037436 DOI: 10.1089/acm.2020.0238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: We aimed to study the short-term effects of Integrated Amrita Meditation (IAM) technique in anxiety and depression states and to have a better understanding on the underlying physiological changes related to short-term and long-term IAM practice. Design: Short-term IAM practitioners (ST-IAM) and long-term IAM practitioners (LT-IAM) were compared to control groups of the same age and naïve to yoga and meditation (ST-control and LT-control, respectively). Settings/Location: Kerala, India. Subjects: People that did not suffer from any major medical condition. All participants were naïve to yoga and meditation practices, except for the 5 LT-IAM practitioners. Intervention: ST-IAM practitioners underwent 2 community IAM practices and 5 individual IAM practices. LT-IAM practitioners (performing IAM regularly for more than 4 years) underwent a community IAM practice before the study. Outcome measures: Anxiety and depression states and physiological parameters from ST-IAM and ST-control groups were assed in two different visits (before and after the week of IAM practice or control condition). LT-IAM and LT-control subjects' physiological measurements were taken in only one visit. Results: Short-term IAM practice significantly decreased anxiety and depression states; two way ANOVA indicated differences on anxiety and depression scores across visits between ST-IAM and ST-control groups (Group effect: F(1, 25) = 6.083, p = 0.0209; F(1, 25) = 4.449, p = 0.0451). However, no changes were observed on their physiological parameters (heart rate, blood pressure, oxygen saturation, and dopamine and GABA plasma levels). Interestingly, LT-IAM practitioners showed increased GABA plasma levels than the LT-control group (p = 0.0358, t = 2.521, df = 8). Conclusions: Our study indicates the possible role of IAM technique on modulations of the plasma GABAergic levels and shows that one week of IAM practice is accompanied by a significant decrease of anxiety and depression states in the healthy population.
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Affiliation(s)
- Laura Lozano Montes
- Department of Physiology, Amrita Institute of Medical Sciences, Cochin, India
| | | | - Suja Gopalakrishnan
- Department of Physiology, Amrita Institute of Medical Sciences, Cochin, India
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Narita K, Amiya E. Social and environmental risks as contributors to the clinical course of heart failure. Heart Fail Rev 2021; 27:1001-1016. [PMID: 33945055 DOI: 10.1007/s10741-021-10116-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2021] [Indexed: 11/28/2022]
Abstract
Heart failure is a major contributor to healthcare expenditures. Many clinical risk factors for the development and exacerbation of heart failure had been reported, including diabetes, renal dysfunction, and respiratory disease. In addition to these clinical parameters, the effects of social factors, such as occupation or lifestyle, and environmental factors may have a great impact on disease development and progression of heart failure. However, the current understanding of social and environmental factors as contributors to the clinical course of heart failure is insufficient. To present the knowledge of these factors to date, this comprehensive review of the literature sought to identify the major contributors to heart failure within this context. Social factors for the risk of heart failure included occupation and lifestyle, specifically in terms of the effects of specific occupations, occupational exposure to toxicities, work style, and sleep deprivation. Socioeconomic factors focused on income and education level, social status, the neighborhood environment, and marital status. Environmental factors included traffic and noise, air pollution, and other climate factors. In addition, psychological stress and behavior traits were investigated. The development of heart failure may be closely related to these factors; therefore, these data should be summarized for the context to improve their effects on patients with heart failure. The present study reviews the literature to summarize these influences.
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Affiliation(s)
- Koichi Narita
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, 113-8655, Tokyo, Japan
| | - Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, 113-8655, Tokyo, Japan. .,Department of Therapeutic Strategy for Heart Failure, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, 113-8655, Tokyo, Japan.
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Being present: Examining the efficacy of an Internet Mantram Program on RN-delivered patient-centered care. Nurs Outlook 2021; 69:136-146. [PMID: 33573826 PMCID: PMC7869680 DOI: 10.1016/j.outlook.2021.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/31/2020] [Accepted: 01/10/2021] [Indexed: 12/30/2022]
Abstract
Background The COVID-19 pandemic highlighted nurses’ compassionate presence during stressful conditions. Strategies to reduce workplace stress are needed. Purpose The purpose of this study was to evaluate a stress reduction strategy, an Internet-based Mantram Repetition Program (MRP), for nurses caring for hospitalized Veterans. Methods A one group pre-/post-test design was used to assess change in nurses’ perceived outcomes after participating in the MRP. A post-test-only design was used to assess hospitalized Veterans’ perceptions of nursing presence and satisfaction with care. Qualitative interviews were used to supplement quantitative data. Findings Patients perceived high levels of presence and satisfaction with care. Post MRP, nurses perceived increased mindfulness, compassion satisfaction, spiritual well-being, and nursing presence. Increased mindfulness was associated with greater compassion satisfaction and less burnout. Discussion For nurses working on the front lines of patient care, the potential for experiencing stress and burnout is a reality. Participating in a MRP could lessen these effects and facilitate nursing presence.
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Chin F, Chou R, Waqas M, Vakharia K, Rai H, Levy E, Holmes D. Efficacy of prayer in inducing immediate physiological changes: a systematic analysis of objective experiments. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 18:679-684. [PMID: 33544510 DOI: 10.1515/jcim-2020-0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 12/29/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess the immediate impact of prayer on physiological state by systematically reviewing objective, controlled experimental studies in the literature. CONTENT Experimental studies measuring objective physiological changes induced by prayer. Studies containing the keyword, "Prayer" anywhere in the title or abstract were curated from the following databases: Public/Publisher Medline (PubMed), Excerpta Medica Database (EMBASE) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) in May 2019. Titles and abstracts were screened with the remaining 30 articles analyzed for inclusion. Only experimental studies were included. SUMMARY Eight experimental studies were identified of which five investigated neurocognitive changes and three investigated systemic physiological changes during prayer. The five studies focusing on neuroactivity used functional MRI (fMRI), electroencephalography or SPECT imaging to obtain measurements. The remaining three studies analyzed an array of systemic physiological metrics, including blood pressure, heart rate, respiratory rate, peripheral resistance, baroreceptor sensitivity and/or cardiovascular rhythm variability during prayer. All studies aside from one saw objective changes during prayer. Neurocognitive changes were mainly associated with improved mental functioning, control and pain tolerance. Prayer was found to slow down physiological functions in two of the three vital-based studies, with the third reporting no change in physiological status. None of the studies measured blood marker changes. OUTLOOK Experimental studies show prayer to induce healthy neurocognitive and physiological changes. Additional studies exploring objective measures from prayer are encouraged to provide practitioners with a more nuanced, scientific perspective when it comes to prescribing prayer as a complementary and alternative medicine (CAM) therapy.
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Affiliation(s)
- Felix Chin
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA
| | - Ryan Chou
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Muhammad Waqas
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA
| | - Kunal Vakharia
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA
| | - Hamid Rai
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA
| | - Elad Levy
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA
| | - David Holmes
- Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
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Effects of diaphragmatic deep breathing exercises on prehypertensive or hypertensive adults: A literature review. Complement Ther Clin Pract 2021; 43:101315. [PMID: 33530033 DOI: 10.1016/j.ctcp.2021.101315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/07/2021] [Accepted: 01/21/2021] [Indexed: 12/30/2022]
Abstract
Diaphragmatic breathing, a deep breathing technique, has been reported to improve autonomic function by reducing sympathetic activity and increasing baroreflex sensitivity. This literature review aimed to (1) examine the effects of diaphragmatic breathing on physiological and psychological measures in prehypertensive or hypertensive adults and to (2) determine the appropriate length, frequency, and duration of an effective diaphragmatic breathing exercise in the management of prehypertension and hypertension. Relevant studies were searched using electronic databases, and 13 studies that met the inclusion criteria were included. The synthesis of the findings revealed that voluntary diaphragmatic deep breathing resulted in decreased of systolic and diastolic blood pressures, reduced heart rate, a relaxing effect, and reduced anxiety in hypertensive or prehypertensive individuals. It is concluded that voluntary diaphragmatic breathing at <10 or 6 breaths per minute for 10 min twice a day for 4 weeks was effective in producing positive outcomes. The results of this review provide directions for related interventions and future research.
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36
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Coupling between Blood Pressure and Subarachnoid Space Width Oscillations during Slow Breathing. ENTROPY 2021; 23:e23010113. [PMID: 33467769 PMCID: PMC7830105 DOI: 10.3390/e23010113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/29/2020] [Accepted: 01/12/2021] [Indexed: 12/14/2022]
Abstract
The precise mechanisms connecting the cardiovascular system and the cerebrospinal fluid (CSF) are not well understood in detail. This paper investigates the couplings between the cardiac and respiratory components, as extracted from blood pressure (BP) signals and oscillations of the subarachnoid space width (SAS), collected during slow ventilation and ventilation against inspiration resistance. The experiment was performed on a group of 20 healthy volunteers (12 females and 8 males; BMI =22.1±3.2 kg/m2; age 25.3±7.9 years). We analysed the recorded signals with a wavelet transform. For the first time, a method based on dynamical Bayesian inference was used to detect the effective phase connectivity and the underlying coupling functions between the SAS and BP signals. There are several new findings. Slow breathing with or without resistance increases the strength of the coupling between the respiratory and cardiac components of both measured signals. We also observed increases in the strength of the coupling between the respiratory component of the BP and the cardiac component of the SAS and vice versa. Slow breathing synchronises the SAS oscillations, between the brain hemispheres. It also diminishes the similarity of the coupling between all analysed pairs of oscillators, while inspiratory resistance partially reverses this phenomenon. BP–SAS and SAS–BP interactions may reflect changes in the overall biomechanical characteristics of the brain.
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Oman D, Bormann JE, Kane JJ. Mantram Repetition as a Portable Mindfulness Practice: Applications During the COVID-19 Pandemic. Mindfulness (N Y) 2020; 13:1418-1429. [PMID: 33224309 PMCID: PMC7667218 DOI: 10.1007/s12671-020-01545-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 12/12/2022]
Abstract
Objective Mantram or holy name repetition has long been practiced in every major religious tradition. Repetition of a mantram as a mindfulness practice is helpful for stress management and resilience building. The objective of this article is to provide an overview of the key features of mantram and the Mantram Repetition Program (MRP) developed in the US Veterans Healthcare System, the evidence base for the MRP, and its applications. Methods MRP practices are portable and do not require an extended or regularized period of sitting, in contrast to most methods of meditation. Core functions of MRP practices include focus shifting, frame activation, and fostering of mindfulness. We review scientific research, including multiple randomized trials, that has investigated the MRP. Results Research on the MRP has documented reductions in posttraumatic stress symptoms, insomnia, hyperarousal, and depression, as well as enhancement of quality of life, self-efficacy, and mindfulness. Mantram repetition may possess comparative advantages for managing symptoms of various mental health conditions, including posttraumatic stress disorder, HIV/AIDS, cancer, and chronic diseases. Conclusions MRP practices can be integrated into daily routines to manage stress and improve coping, safety, efficacy, calmness, and resilience. The inclusion of mantram repetition alongside conventional mindfulness-based practices for stress management will improve their cultural and religious inclusiveness, enabling societies and organizations to build greater collective resilience. Mantram repetition can be readily used in the COVID-19 pandemic, focusing on healthcare workers, patients, and the public.
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Affiliation(s)
- Doug Oman
- School of Public Health, University of California, 2121 Berkeley Way, Room #5302, Berkeley, CA 94720-7360 USA
| | - Jill E. Bormann
- Hahn School of Nursing and Health Sciences/Beyster Institute of Nursing Research, University of San Diego, 5998 Alcala Park, San Diego, CA 92110-2492 USA
| | - Jim J. Kane
- Department of Education, Development & Research, Hillcrest Medical Center, University of California, San Diego, 402 Dickinson St. Mail Code 8929, San Diego, CA 92103 USA
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Bachler M, Sehnert W, Mikisek I, Wassertheurer S, Mengden T. Non-invasive quantification of the effect of device-guided slow breathing with direct feedback to the patient to reduce blood pressure. Physiol Meas 2020; 41:104002. [PMID: 33164912 DOI: 10.1088/1361-6579/abb320] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Slow breathing is a relaxation exercise recommended for lowering blood pressure (BP). Biofeedback may improve patient adherence and enhance BP lowering effects. Since the pulse arrival time (PAT) is inversely proportional to BP, it can be used to estimate BP changes. APPROACH In this pilot study, 30 patients (age 62.9 (SD 7.7) years, 11 F/19 M, Sys. BP 133.0 (SD 17.1) mmHg, Dia. BP 83.8 (SD 10.6) mmHg) performed a device-guided slow breathing exercise. PAT was measured by ECG and plethysmography and immediately presented to the patient, and respiratory sinus arrhythmia (RSA) was calculated retrospectively to measure the adherence to the instructed respiratory rate. MAIN RESULTS Respiratory rate was 13.6 (SD 1.9) bpm at baseline and 5.4 (SD 1.0) bpm during guided breathing. PAT continuously and progressively increased from 231.5 (SD 20.3) to 237.3 (SD 18.5) ms (p [Formula: see text] 0.001). The median deviation of RSA from the guided respiratory rate was 0.06 (IQR 0.19) bpm. In three patients, a deviation of > 0.20 bpm was detected, and two of them showed no increase in PAT. In total, 25 patients responded with increase in PAT. SIGNIFICANCE In this pilot study we have shown that biofeedback of PAT and RSA are feasible and can further improve motivation and adherence. Furthermore, we have shown that the exercise increased PAT, which indicates a reduction in BP. Due to its ease of use, this method is ideal for home use and self-monitoring.
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Affiliation(s)
- Martin Bachler
- AIT Austrian Institute of Technology, Center for Health & Bioresources, Vienna, Austria
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Gupta D. "N95/N99" peri-procedure diapers during lower gastrointestinal endoscopies. Med Hypotheses 2020; 144:110026. [PMID: 32758872 PMCID: PMC7313482 DOI: 10.1016/j.mehy.2020.110026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/20/2020] [Indexed: 11/24/2022]
Abstract
It is important to consider lower gastrointestinal endoscopies (LGIE) as aerosol-generating procedures. Thus, it may be better to protect room environments by ensuring patients wearing peri-procedure diapers (PPD) to contain infectious colorectal gas expulsions because fecal SARS-CoV-2 has been detected among COVID-19 patients even after they have undetectable nasopharyngeal SARS-CoV-2. Summarily, PPD among LGIE patients can potentially evolve as standard barrier modality.
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Affiliation(s)
- Deepak Gupta
- Wayne State University/Detroit Medical Center, Box No 162, 3990 John R, Detroit, MI 48201, United States.
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Gholamrezaei A, Van Diest I, Aziz Q, Vlaeyen JWS, Van Oudenhove L. Psychophysiological responses to various slow, deep breathing techniques. Psychophysiology 2020; 58:e13712. [PMID: 33111377 DOI: 10.1111/psyp.13712] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 10/03/2020] [Accepted: 10/04/2020] [Indexed: 02/02/2023]
Abstract
Deep breathing exercises are commonly used for several health conditions including pain and hypertension. Various techniques are available to practice deep breathing, whereas possible differential psychophysiological effects have not been investigated. We compared four deep breathing techniques and examined outcomes in blood pressure variability, respiratory sinus arrhythmia, baroreflex function, and emotional state. Healthy adult volunteers performed pursed-lips breathing, left and right unilateral nostril breathing, and deep breathing with an inspiratory threshold load (loaded breathing), all at a frequency of 0.1 Hz (i.e., controlled breathing) and for three minutes each. Results showed that blood pressure variability was higher during loaded breathing versus other conditions and higher during pursed-lips breathing versus left and right unilateral nostril breathing. Respiratory sinus arrhythmia was higher during loaded breathing versus other conditions and higher during pursed-lips breathing versus left unilateral nostril breathing. The effect of breathing condition on respiratory sinus arrhythmia was mediated by alterations in blood pressure variability. There was no difference between the breathing conditions in baroreflex sensitivity or effectiveness. Participants rated pursed-lips breathing as more calming and pleasant and with more sense of control (vs. other conditions). Overall, among the four tested deep breathing techniques, loaded breathing was associated with enhanced cardiovascular effects and pursed-lips breathing with better emotional responses, while also enhancing cardiovascular effects (albeit less than loaded breathing). These findings can be informative in applying deep breathing techniques as self-management interventions for health conditions, in which baroreceptors stimulation and autonomic and emotional modulations can be beneficial, such as pain and hypertension.
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Affiliation(s)
- Ali Gholamrezaei
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Laboratory for Brain-Gut Axis Studies, Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Ilse Van Diest
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Qasim Aziz
- Centre for Neuroscience, Surgery and Trauma, Blizard Institute, Wingate Institute of Neurogastroeneterology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Johan W S Vlaeyen
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Experimental Health Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Lukas Van Oudenhove
- Laboratory for Brain-Gut Axis Studies, Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
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Mendoza-Castejon D, Fraile-García J, Diaz-Manzano M, Fuentes-Garcia JP, Clemente-Suárez VJ. Differences in the autonomic nervous system stress status of urban and rural school teachers. Physiol Behav 2020; 222:112925. [DOI: 10.1016/j.physbeh.2020.112925] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/05/2020] [Accepted: 04/10/2020] [Indexed: 01/11/2023]
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Abstract
PURPOSE Cardiovascular disease continues to be the leading cause of morbidity and mortality around the world. Yoga, a combination of physical postures (asana), breathing exercises (pranayama), and meditation (dhyana), has gained increasing recognition as a form of mind-body exercise. In this narrative review, we intended to review the emerging evidence assessing the physiologic and clinical effects of yoga on the cardiovascular system and the potential role of yoga as a component of comprehensive cardiac rehabilitation. METHODS We searched PubMed, Google Scholar, Embase, and Cochrane databases for literature related to cardiovascular effects of yoga from inception up until 2017. RESULTS Yoga has been shown to have favorable effects on systemic inflammation, stress, the cardiac autonomic nervous system, and traditional and emerging cardiovascular risk factors. CONCLUSIONS Yoga has shown promise as a useful lifestyle intervention that can be incorporated into cardiovascular disease management algorithms. Although many investigators have reported the clinical benefits of yoga in reducing cardiovascular events, morbidity, and mortality, evidence supporting these conclusions is somewhat limited, thereby emphasizing the need for large, well-designed randomized trials that minimize bias and methodological drawbacks.
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Chen SM, Wang LY, Wu PJ, Liaw MY, Chen YL, Chen AN, Tsai TH, Hang CL, Lin MC. The Interrelationship between Ventilatory Inefficiency and Left Ventricular Ejection Fraction in Terms of Cardiovascular Outcomes in Heart Failure Outpatients. Diagnostics (Basel) 2020; 10:E469. [PMID: 32664450 PMCID: PMC7399946 DOI: 10.3390/diagnostics10070469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/28/2022] Open
Abstract
The relationship between left ventricular ejection fraction (LVEF) and cardiovascular (CV) outcome is documented in patients with low LVEF. Ventilatory inefficiency is an important prognostic predictor. We hypothesized that the presence of ventilatory inefficiency influences the prognostic predictability of LVEF in heart failure (HF) outpatients. In total, 169 HF outpatients underwent the cardiopulmonary exercise test (CPET) and were followed up for a median of 9.25 years. Subjects were divided into five groups of similar size according to baseline LVEF (≤39%, 40-58%, 59-68%, 69-74%, and ≥75%). The primary endpoints were CV mortality and first HF hospitalization. The Cox proportional hazard model was used for simple and multiple regression analyses to evaluate the interrelationship between LVEF and ventilatory inefficiency (ventilatory equivalent for carbon dioxide (VE/VCO2) at anaerobic threshold (AT) >34.3, optimized cut-point). Only LVEF and VE/VCO2 at AT were significant predictors of major CV events. The lower LVEF subgroup (LVEF ≤ 39%) was associated with an increased risk of CV events, relative to the LVEF ≥75% subgroup, except for patients with ventilatory inefficiency (p = 0.400). In conclusion, ventilatory inefficiency influenced the prognostic predictability of LVEF in reduced LVEF outpatients. Ventilatory inefficiency can be used as a therapeutic target in HF management.
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Affiliation(s)
- Shyh-Ming Chen
- Section of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (P.-J.W.); (Y.-L.C.); (T.-H.T.); (C.-L.H.)
| | - Lin-Yi Wang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (L.-Y.W.); (M.-Y.L.)
| | - Po-Jui Wu
- Section of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (P.-J.W.); (Y.-L.C.); (T.-H.T.); (C.-L.H.)
| | - Mei-Yun Liaw
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (L.-Y.W.); (M.-Y.L.)
| | - Yung-Lung Chen
- Section of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (P.-J.W.); (Y.-L.C.); (T.-H.T.); (C.-L.H.)
| | - An-Ni Chen
- Department of Physical Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan;
| | - Tzu-Hsien Tsai
- Section of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (P.-J.W.); (Y.-L.C.); (T.-H.T.); (C.-L.H.)
| | - Chi-Ling Hang
- Section of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (P.-J.W.); (Y.-L.C.); (T.-H.T.); (C.-L.H.)
| | - Meng-Chih Lin
- Section of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Chang Gung University College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan;
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Ghati N, Killa AK, Sharma G, Karunakaran B, Agarwal A, Mohanty S, Nivethitha L, Siddharthan D, Pandey RM. A randomized trial of the immediate effect of Bee-Humming Breathing exercise on blood pressure and heart rate variability in patients with essential hypertension. Explore (NY) 2020; 17:312-319. [PMID: 32620379 DOI: 10.1016/j.explore.2020.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 03/22/2020] [Accepted: 03/24/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Bee-Humming Breathing (BHB) exercise is a simple yogic practice recommended for its favorable effect on cardiac physiology, including blood pressure (BP) and autonomic nervous system. However, strong evidence supporting its effectiveness is lacking. The present study was designed to evaluate the immediate effect of BHB exercise on blood pressure parameters and heart rate variability (HRV) in patients with essential hypertension. STUDY METHODS We conducted a randomized control trial including 70 patients with essential hypertension, randomly allocated to perform either BHB exercise (n=35) or placebo slow breathing exercise (n = 35) for 5-minutes duration. Blood pressure and HRV were measured before, during, and after the practice. RESULTS There was no significant decrease in systolic [effect size (95% CI): 2.22 (-13.20, 17.64); p 0.77], diastolic [4.54 (-17.40, 26.48); p 0.68] and mean blood pressures [1.37 (-8.78, 11.52); p 0.78] after BHB exercise in comparison to the control group in our study. The HRV analysis showed a significant increase in the HF power [6.8 (1.47, 12.12); p 0.01], and decrease in the LF power [-26.47 (-34.25, -18.68); p < 0.01] during the recovery phase of the 5-minute BHB exercise in comparison to the control group. CONCLUSIONS This is the first randomized controlled trial to show that though a single short session of BHB exercise in hypertensive patients does not significantly reduce BP, it significantly augments the parasympathetic tone as indicated by a significant improvement in HRV parameters. CLINICAL TRIAL REGISTRATION NUMBER CTRI/2018/08/015215.
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Affiliation(s)
- Nirmal Ghati
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Avantika K Killa
- Center for Integrative Medicine and Research (CIMR), All India Institute of Medical Sciences, New Delhi, India
| | - Gautam Sharma
- Center for Integrative Medicine and Research (CIMR); Professor, Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Biju Karunakaran
- Center for Integrative Medicine and Research (CIMR), All India Institute of Medical Sciences, New Delhi, India
| | - Aman Agarwal
- Center for Integrative Medicine and Research (CIMR), All India Institute of Medical Sciences, New Delhi, India
| | - Sriloy Mohanty
- Center for Integrative Medicine and Research (CIMR), All India Institute of Medical Sciences, New Delhi, India
| | - L Nivethitha
- Center for Integrative Medicine and Research (CIMR), All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Siddharthan
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - R M Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
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Kornej J, Börschel CS, Benjamin EJ, Schnabel RB. Epidemiology of Atrial Fibrillation in the 21st Century: Novel Methods and New Insights. Circ Res 2020; 127:4-20. [PMID: 32716709 DOI: 10.1161/circresaha.120.316340] [Citation(s) in RCA: 656] [Impact Index Per Article: 164.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Accompanying the aging of populations worldwide, and increased survival with chronic diseases, the incidence and prevalence of atrial fibrillation (AF) are rising, justifying the term global epidemic. This multifactorial arrhythmia is intertwined with common concomitant cardiovascular diseases, which share classical cardiovascular risk factors. Targeted prevention programs are largely missing. Prevention needs to start at an early age with primordial interventions at the population level. The public health dimension of AF motivates research in modifiable AF risk factors and improved precision in AF prediction and management. In this review, we summarize current knowledge in an attempt to untangle these multifaceted associations from an epidemiological perspective. We discuss disease trends, preventive opportunities offered by underlying risk factors and concomitant disorders, current developments in diagnosis and risk prediction, and prognostic implications of AF and its complications. Finally, we review current technological (eg, eHealth) and methodological (artificial intelligence) advances and their relevance for future prevention and disease management.
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Affiliation(s)
- Jelena Kornej
- From the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts & Sections of Cardiovascular Medicine and Preventive Medicine, Boston Medical Center (J.K., E.J.B.), Boston University School of Medicine, MA
| | - Christin S Börschel
- Department of General and Interventional Cardiology, University Heart & Vascular Center Hamburg Eppendorf, Hamburg, Germany (C.B., R.B.S.)
- German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck (C.B., R.B.S.)
| | - Emelia J Benjamin
- From the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts & Sections of Cardiovascular Medicine and Preventive Medicine, Boston Medical Center (J.K., E.J.B.), Boston University School of Medicine, MA
- Department of Epidemiology (E.J.B.), Boston University School of Medicine, MA
| | - Renate B Schnabel
- Department of General and Interventional Cardiology, University Heart & Vascular Center Hamburg Eppendorf, Hamburg, Germany (C.B., R.B.S.)
- German Center for Cardiovascular Research (DZHK) partner site Hamburg/Kiel/Lübeck (C.B., R.B.S.)
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Koch AK, Schöls M, Langhorst J, Dobos G, Cramer H. Perceived stress mediates the effect of yoga on quality of life and disease activity in ulcerative colitis. Secondary analysis of a randomized controlled trial. J Psychosom Res 2020; 130:109917. [PMID: 31927346 DOI: 10.1016/j.jpsychores.2019.109917] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/23/2019] [Accepted: 12/31/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Yoga positively affects health-related quality of life and disease activity in ulcerative colitis. The underlying modes of action remain unclear. Within the present study we hypothesized that patients´ perceived stress mediates the effects of yoga on health-related quality of life and disease activity. METHODS This is a secondary analysis of a randomized controlled trial comparing the effects of yoga to written self-care advice in patients with inactive ulcerative colitis and impaired quality of life. Perceived stress was assessed using the Perceived Stress Questionnaire, health-related quality of life using the Inflammatory Bowel Disease Questionnaire and disease activity using the Clinical Activity Index. Outcomes were assessed at weeks 0, 12 and 24. RESULTS Seventy-seven patients participated. Thirty-nine patients attended the 12 supervised weekly yoga sessions (71.8% women; 45.0 ± 13.3 years) and 38 patients written self-care advice (78.9% women; 46.1 ± 10.4 years). Perceived stress correlated significantly with health-related quality of life and disease activity at week 24. Perceived stress at week 12 fully mediated the effects of yoga on health-related quality of life (B = 16.23; 95% Confidence interval [6.73; 28.40]) and disease activity (B = -0.28; 95% Confidence interval [-0.56; -0.06]) at week 24. CONCLUSION Our findings confirm the importance of perceived stress in reducing disease activity and increasing health-related quality of life in patients with ulcerative colitis and impaired quality of life. Practitioners should keep psychosocial risk in mind as a risk factor for disease exacerbation, and consider yoga as an adjunct intervention for highly stressed patients with ulcerative colitis. CLINICALTRIALS. GOV REGISTRATION NUMBER The trial was registered at clinicaltrials.gov prior to patient recruitment (registration number NCT02043600).
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Affiliation(s)
- Anna K Koch
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
| | - Margarita Schöls
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Klinikum Bamberg, Bamberg, Germany.
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
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Celka P, Granqvist N, Schwabl H, Edwards SD. Development and evaluation of a cardiac coherence index for sleep analysis. JOURNAL OF PSYCHOLOGY IN AFRICA 2020. [DOI: 10.1080/14330237.2019.1689460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Patrick Celka
- SATHeart SA, Rue Galilée, Yverdon-les-Bains, Switzerland
| | | | | | - Stephen D. Edwards
- Psychology Department, University of Zululand, KwaDlangezwa, South Africa
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Binaural Beats through the Auditory Pathway: From Brainstem to Connectivity Patterns. eNeuro 2020; 7:ENEURO.0232-19.2020. [PMID: 32066611 PMCID: PMC7082494 DOI: 10.1523/eneuro.0232-19.2020] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 12/23/2019] [Accepted: 01/20/2020] [Indexed: 01/13/2023] Open
Abstract
Binaural beating is a perceptual auditory illusion occurring when presenting two neighboring frequencies to each ear separately. Several controversial claims have been attributed to binaural beats regarding their ability to entrain human brain activity and mood, in both the scientific literature and the marketing realm. Here, we sought to address those questions in a robust fashion using a single-blind, active-controlled protocol. To do so, we compared the effects of binaural beats with a control beat stimulation (monaural beats, known to entrain brain activity but not mood) across four distinct levels in the human auditory pathway: subcortical and cortical entrainment, scalp-level functional connectivity and self-reports. Both stimuli elicited standard subcortical responses at the pure tone frequencies of the stimulus [i.e., frequency following response (FFR)], and entrained the cortex at the beat frequency [i.e., auditory steady state response (ASSR)]. Furthermore, functional connectivity patterns were modulated differentially by both kinds of stimuli, with binaural beats being the only one eliciting cross-frequency activity. Despite this, we did not find any mood modulation related to our experimental manipulation. Our results provide evidence that binaural beats elicit cross frequency connectivity patterns, but weakly entrain the cortex when compared with monaural beat stimuli. Whether binaural beats have an impact on cognitive performance or other mood measurements remains to be seen and can be further investigated within the proposed methodological framework.
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Maric V, Ramanathan D, Mishra J. Respiratory regulation & interactions with neuro-cognitive circuitry. Neurosci Biobehav Rev 2020; 112:95-106. [PMID: 32027875 PMCID: PMC10092293 DOI: 10.1016/j.neubiorev.2020.02.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 01/17/2020] [Accepted: 02/02/2020] [Indexed: 01/01/2023]
Abstract
It is increasingly being recognized that active control of breathing - a key aspect of ancient Vedic meditative practices, can relieve stress and anxiety and improve cognition. However, the underlying mechanisms of respiratory modulation of neurophysiology are just beginning to be elucidated. Research shows that brainstem circuits involved in the motor control of respiration receive input from and can directly modulate activity in subcortical circuits, affecting emotion and arousal. Meanwhile, brain regions involved in the sensory aspects of respiration, such as the olfactory bulb, are like-wise linked with wide-spread brain oscillations; and perturbing olfactory bulb activity can significantly affect both mood and cognition. Thus, via both motor and sensory pathways, there are clear mechanisms by which brain activity is entrained to the respiratory cycle. Here, we review evidence gathered across multiple species demonstrating the links between respiration, entrainment of brain activity and functional relevance for affecting mood and cognition. We also discuss further linkages with cardiac rhythms, and the potential translational implications for biorhythm monitoring and regulation in neuropsychiatric disorders.
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Affiliation(s)
- Vojislav Maric
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Dhakshin Ramanathan
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Department of Mental Health, VA San Diego Medical Center, San Diego, CA, USA
| | - Jyoti Mishra
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
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