Abstract
Heart rate variability (HRV) is an indicator of dynamic adaptability of the autonomic nervous system. Few interventions target upstream, cerebral cortex components of the heart-brain system for autonomic management. We report changes in HRV and baroreflex sensitivity (BRS), associated with use of a noninvasive, closed-loop, allostatic, computer-guided, acoustic stimulation neurotechnology. Over 5 years, 220 subjects with heterogeneous neurological, cardiovascular, and psychophysiological conditions consecutively enrolled in a naturalistic, single-arm study exploring clinical effects associated with use of the neurotechnology. Of those, 202 completed the study protocol and 160 had recordings adequate to analyze HRV and BRS. Mean age was 44.0 (SD 19.4), with 130 women. Participants received a mean of 16.1 (5.2) sessions, over 24.2 days (23.3), with 9.5 (3.8) actual intervention days. Sessions included real-time analysis of brain electrical activity and software algorithm-guided translation of selected frequencies into patterns of acoustic stimulation (audible tones of variable pitch and timing), to facilitate auto-calibration of neural oscillations. Outcomes including 10-min supine, at-rest recordings of blood pressure and heart rate, and inventories for insomnia (ISI) and depression (CES-D or BDI-II), were obtained at baseline and 15.3 (16.7) days after the last session. Compared to baseline, significant increases (all p < 0.001) were observed for measures of HRV across all participants including the mean percentage change for SDNN 24.2% (SE 0.04), and RMSSD, 42.2% (0.08), and BRS [Sequence Up, 55.5% (0.09), Sequence Down, 77.6% (0.23), and Sequence All, 53.7% (0.07)]. Significant improvements were noted in SAP, MAP, and DAP, as well as natural log of HF, and total power. Self-reported ISI was reduced (ISI, -6.4 points, SD 5.6, p < 0.001). The proportion reporting clinically significant depressive symptoms reduced from 48.2% at baseline to 22.1% at follow-up. Linear regression showed that rightward asymmetry predicted lower SDNN (p = 0.02). Exploratory analysis showed a trend for improved balance of temporal lobe high-frequency amplitudes over the course of initial sessions. These findings indicate that use of a noninvasive, allostatic, closed-loop neurotechnology appears to have robust potential for public health efforts to support greater flexibility in autonomic cardiovascular regulation, through self-optimization of electrical activity at the level of the brain.
Highlights
Numerous studies have shown that heart rate variability (HRV) is a useful physiological indicator of dynamic adaptability in the autonomic nervous system
The bihemispheric autonomic model for management of traumatic stress (BHAM) begins with recognition that the right and left hemispheres are primarily responsible for cortical management of the sympathetic and parasympathetic divisions, respectively [10]
The BHAM suggests that temporal lobe electrical asymmetry may be an indication of traumatic stress exposure, associated with health effects including reduced HRV, and the model proposes that intervention to reduce asymmetrical activity may be a way to facilitate a state of enhanced autonomic regulation, including increased HRV
Summary
Numerous studies have shown that heart rate variability (HRV) is a useful physiological indicator of dynamic adaptability in the autonomic nervous system. An intriguing question is whether focused engagement of critical central structures, especially those known to have specific roles for autonomic management, may be a way to produce more efficient or pronounced effects on HRV. The BHAM suggests that temporal lobe electrical asymmetry may be an indication of traumatic stress exposure, associated with health effects including reduced HRV, and the model proposes that intervention to reduce asymmetrical activity may be a way to facilitate a state of enhanced autonomic regulation, including increased HRV. Heart rate variability (HRV) is an indicator of dynamic adaptability of the autonomic nervous system. We report changes in HRV and baroreflex sensitivity (BRS), associated with use of a noninvasive, closed-loop, allostatic, computer-guided, acoustic stimulation neurotechnology
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