Abstract:
Interoceptive dysfunctions are increasingly implicated in a number of physical and mental health conditions. Accordingly, there is a pertinent need for therapeutic interventions which target interoceptive deficits. Heartrate and heartrate variability biofeedback therapy (HR(V)-BF), interventions which train individuals to regulate their cardiovascular signals and constrain these within optimal parameters through breathing, could enhance the functioning of interoceptive pathways via stimulation of the vagus nerve. Consequently, this narrative systematic review sought to synthesise the current state of the literature with regard to the potential of HR(V)-BF as an interoceptive intervention across behavioural, physiological and neural outcome measures related to interoception. In total, 77 papers were included in this review, with the majority using physiological outcome measures. Overall, findings were mixed with respect to improvements in the outcome measures after HR(V)-BF. However, trends suggested that effects on measures related to interoception were stronger when resonance frequency breathing and an intense treatment protocol were employed. Based on these findings, we propose a three-stage model by which HR(V)-BF may improve interoception which draws upon principles of interoceptive inference and predictive coding. Furthermore, we provide specific directions for future research, which will serve to advance the current knowledge state.
摘要:
交互感受障碍越来越多地与许多身心健康状况有关。因此,有针对性的治疗性干预措施,以相互感受缺陷为目标。心率和心率变异性生物反馈治疗(HR(V)-BF),干预措施,训练个人调节他们的心血管信号,并通过呼吸将这些信号限制在最佳参数内,可以通过刺激迷走神经增强感觉通路的功能。因此,这篇叙述性系统综述试图综合文献的现状,关于HR(V)-BF作为跨行为的交互感受干预的潜力,与相互感觉相关的生理和神经结果测量。总的来说,这篇综述包括77篇论文,大多数人使用生理结果测量。总的来说,在HR(V)-BF后结局指标的改善方面,研究结果喜忧参半。然而,趋势表明,当采用共振频率呼吸和高强度治疗方案时,对与相互感觉相关的措施的影响更强。基于这些发现,我们提出了一个三阶段模型,通过该模型,HR(V)-BF可以改善互感,该模型借鉴了互感推理和预测编码的原理。此外,我们为未来的研究提供了具体的方向,这将有助于推进当前的知识状态。