Effect of an eight-week smartphone-guided HRV-biofeedback intervention on autonomic function and impulsivity in healthy controls

Abstract

A large body of scientific studies suggest a close relationship between increased vagal function and better cognitive performance. Objective: In the current study, we investigated the association between autonomic function and behavioral impulsivity. We hypothesized that heart rate variability (HRV) biofeedback training increases HRV and enhances inhibitory control. Approach: A total of 28 healthy participants were recruited. After drop-out, 14 participants completed an eight-week HRV biofeedback training with five training sessions per week including one session at the clinic’s laboratory and four sessions at home using a mobile application running on their smartphone. Ten control subjects matched with respect to age and gender played a mobile game according to the same schedule as the biofeedback group. The assessment of autonomic status and the stop-signal task were conducted before the beginning of the training (T1) and after finishing the schedule (T2). Main results: We found a relationship of reaction times in the stop-signal task and standard HRV as well as cardiorespiratory indices. After biofeedback training, short-term HRV and baroreflex function significantly increased by 33% (CI [2%, 64%], p < 0.05) and 21% (CI [5%, 36%], p < 0.05), respectively. The performance in the stop-signal task was not affected by the biofeedback intervention. Compared to the changes of autonomic indices in the control group, only a decrease of skin conductance levels in the biofeedback group remained statistically significant. Significance: Our results indicate that a smartphone-based HRV biofeedback intervention can be applied to improve cardiovagal function in healthy subjects. Although higher HRV was associated with higher levels of inhibitory control, HRV biofeedback had no effect on measures of impulsivity.