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Sensory rooms are those equipped with various visual, auditory, and other sensory items that can be adjusted according to user preferences. Although several studies have reported the effectiveness of sensory rooms, their physiological effects remain unclear. This pilot study aims to investigate the effect of sensory rooms on vagal function, mood states, and attentional functions. Thirty-nine healthy young adults were randomly divided into the sensory room intervention (SRI) and sedentary activity (SA) groups, and given a 30-minute intervention. The SRI group spent time in a dimly lit room with beaded cushions and aroma oils. The SA group engaged in activities such as handicrafts and puzzles. We compared changes in respiratory sinus arrhythmia (RSA) at rest, RSA variability during discomfort sensory stimulation, mood states, and attentional functions between the groups, both before and after the intervention. As a result, 1) SRI significantly increased RSA compared with SA. 2) It also reduced the variability of RSA in response to specific sensory stimuli compared with SA. 3) However, no significant differences existed in negative mood or attentional function between the groups. The results suggest that sensory rooms might contribute to the sensory modulation, including that of the autonomic nervous system. Further investigation with larger samples in clinical settings, particularly among individuals with sensory modulation issues and mental illness, is necessary to confirm and generalize these findings.

Breathing exercises with biofeedback have benefits over breathing exercises without biofeedback. However, the traditional measurement of respiratory signals that is required as part of feeding back the breath incurs high cost and effort. We propose a novel virtual reality (VR) based approach to respiratory biofeedback that utilizes the positionally tracked hand controllers integrated into modern VR systems to capture and feedback the respiration-induced abdominal movements. In a randomized controlled laboratory study, we investigated the feasibility and efficacy of the developed biofeedback algorithm. In total, 72 participants performed a short breathing exercise in VR with or without respiratory biofeedback. The feedback integration resulted in a satisfactory user experience, a heightened breath awareness, a greater focus on slow diaphragmatic breathing and an increased respiratory sinus arrhythmia. This evidences that the novel biofeedback approach is low-cost, unobtrusive, usable and effective in increasing breath awareness and promoting slow diaphragmatic breathing in the context of VR-based breathing exercises. Future studies need to investigate the broader applicability and long-term effects.

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a well-established treatment for pediatric posttraumatic stress disorder (PTSD). Animal-assisted therapy (AAT) has been proposed as an adjunct to TF-CBT that may improve treatment effects through enhanced targeting of affect regulation, as indexed by specific changes in the respiratory sinus arrhythmia (RSA). The current study reports results from a randomized controlled feasibility trial (N = 33; Mage = 11.79 [SD = 3.08]; 64% White; 67% female) that measured RSA during Sessions 1, 4, 8, and 12 of a twelve-session TF-CBT protocol and tested whether: 1) TF-CBT + AAT achieved higher average RSA amplitudes relative to TF-CBT alone, and 2) RSA regulation, defined as less variability around person-specific RSA slopes during treatment, explained variation in post-treatment PTSD symptoms. Multilevel modeling failed to support an effect for TF-CBT + AAT on RSA amplitudes (δ001 = 0.08, p = 0.844). However, regardless of treatment condition, greater RSA withdrawal was observed within Sessions 4 (γ11 = -.01, p < .001) and 12 (γ13 = -.01, p = .015) relative to the Session 1 baseline. The average level of RSA amplitude in Session 8 was also significantly lower compared to Session 1 (γ02 = -0.70, p = .046). Intraindividual regression models demonstrated that greater RSA regulation predicted improved PTSD symptoms at post-treatment after adjusting for pre-treatment levels (b3 = 20.00, p = .012). These preliminary results offer support for future confirmatory trials testing whether affect regulation, as indexed by changes in RSA, is a mechanism of action for TF-CBT in the treatment of pediatric PTSD.

The interaction of physical and mental vulnerability and environmental constraints is thought to foster the development of psychiatric disorders such as major depressive disorder (MDD). A central factor in the development of psychopathology is mental stress. Despite some evidence for parasympathetic withdrawal and sympathetic overactivity in MDD, the psychophysiological response to stress in depression is not clear-cut. Given the growing interest in heart rate and heart rate variability as indicators for remote monitoring of patients, it is important to understand how patients with MDD react to stress in a laboratory-controlled environment. We conducted a systematic review of studies using electrocardiography to derive heart rate and heart rate variability during stress in patients with clinical depression. We focused on well-validated stress tasks- the mental arithmetic stress task, the Trier social stress task and public speaking task- to minimize confounding effects due to the nature of the stressor. The majority of studies found hypo-reactivity during stress as a hallmark of depression as evidenced by lower fluctuation in heart rate and heart rate variability in the high-frequency band. We address the potential underlying biological mechanisms, the influence of covariates on these measures and briefly discuss the specificity and potential for remote monitoring by using these variables.

Heart rate variability (HRV) is a crucial indicator of cardiovascular health. Low HRV is correlated with disease severity and mortality in heart failure. Heart rate increases and decreases with each breath in normal physiology termed respiratory sinus arrhythmia (RSA). RSA is highly evolutionarily conserved, most prominent in the young and athletic and is lost in cardiovascular disease. Despite this, current pacemakers either pace the heart in a metronomic fashion or sense activity in the sinus node. If RSA has been lost in cardiovascular disease current pacemakers cannot restore it. We hypothesized that restoration of RSA in heart failure would improve cardiac function. Restoration of RSA in heart failure was assessed in an ovine model of heart failure with reduced ejection fraction. Conscious 24 h recordings were made from three groups, RSA paced (n = 6), monotonically paced (n = 6) and heart failure time control (n = 5). Real-time blood pressure, cardiac output, heart rate and diaphragmatic EMG were recorded in all animals. Respiratory modulated pacing was generated by a proprietary device (Ceryx Medical) to pace the heart with real-time respiratory modulation. RSA pacing substantially increased cardiac output by 1.4 L/min (20%) compared to contemporary (monotonic) pacing. This increase in cardiac output led to a significant decrease in apnoeas associated with heart failure, reversed cardiomyocyte hypertrophy, and restored the T-tubule structure that is essential for force generation. Re-instating RSA in heart failure improves cardiac function through mechanisms of reverse re-modelling; the improvement observed is far greater than that seen with current contemporary therapies. These findings support the concept of re-instating RSA as a regime for patients who require a pacemaker.

High work stress has been consistently associated with disturbed autonomic balance, specifically, lowered vagal cardiac control and increased sympathetic activity, which may lead to increased cardiovascular risk. Stress management procedures have been proposed to reduce autonomic dysfunctions related to work stress in different categories of workers exposed to heightened work demands, while a limited number of studies addressed this issue in managers. The present study was aimed at evaluating the effectiveness of a respiratory sinus arrhythmia (RSA) biofeedback (BF) intervention on psychological and physiological outcomes, in managers with high-level work responsibilities. Thirty-one managers leading outstanding private or public companies were randomly assigned to either a RSA-BF training (RSA-BF; N = 16) or a control group (N = 15). The RSA-BF training consisted of five weekly 45 min sessions, designed to increase RSA, whereas controls had to provide a daily stress diary once a week. After the training, managers in both groups reported reduced heart rate at rest, lower anxiety levels and improvement in health-related quality of life. More importantly, managers in the RSA-BF group showed increased vagal control (as indexed by increased RSA), decreased sympathetic arousal (as indexed by reduced skin conductance and systolic blood pressure) and lower emotional interferences, compared to managers in the control group. Results from this study showed that RSA-BF training was effective in improving cardiac autonomic balance at rest. Moreover, findings from this study underline the effectiveness of biofeedback in reducing psychophysiological negative outcomes associated with stress in managers.

Purpose The aim of the study was to compare the kinetics responses of heart rate (HR), pulmonary ( V ˙ O 2pulm ), and muscular ( V ˙ O 2musc ) oxygen uptake during dynamic leg exercise across different body positions (−6°, 45°, and 75°). Methods Ten healthy individuals [six men, four women; age 23.4 ± 2.8 years; height 179.7 ± 8.3 cm; body mass 73 ± 12 kg (mean ± SD)] completed pseudo-random binary sequence (PRBS) work rate (WR) changes between 30 and 80 W in each posture. HR was measured beat-to-beat by echocardiogram and V ˙ O 2pulm by breath-by-breath gas exchange. V ˙ O 2musc kinetics were assessed by the procedure of Hoffmann et al. (Eur J Appl Physiol 113:1745–1754, 2013 ) applying a circulatory model and cross-correlation functions (CCF). Results For V ˙ O 2pulm kinetics significant differences between −6° (CCF-values: 0.292 ± 0.040) and 45° (0.256 ± 0.034; p  < 0.01; n  = 10) as well as between −6° and 75° (0.214 ± 0.057; p  < 0.05; n  = 10) were detected at lag ‘40 s’ of the CCF course as interaction effects (factors: Lag  ×  Posture ). HR and V ˙ O 2musc kinetics yield no significant differences across the postures. Conclusions The analysis of cardio-dynamic and respiratory kinetics, especially with an emphasis on muscular and cellular level, has to consider venous return and cardiac output distortions. Simplified observations of kinetics responses resulting in time constants and time delays only should be replaced by the time-series analysis for a more sophisticated evaluation. The results illustrate that isolated V ˙ O 2pulm measurements without cardio-dynamic influences may not represent the kinetics responses originally revealed at muscular level.

Impaired maternal sensitivity may be a risk pathway linking maternal posttraumatic stress symptoms (PTSS) to adverse child outcomes. Respiratory sinus arrhythmia (RSA), a psychophysiological marker of emotion dysregulation, may be a key factor in how PTSS influence maternal sensitivity. Yet, these associations remain untested in early infancy. The current study tested maternal resting RSA and RSA reactivity to caregiving as moderators of the association between maternal PTSS and maternal sensitivity in trauma-exposed mothers. Seventy-seven mother-infant dyads (maternal  = 30.06 years, infant  = 9.53 weeks) were recruited from the community and an urban public hospital setting. Mothers reported on PTSS and engaged in a caregiving task; maternal sensitivity was coded. RSA was measured at rest and in response to the task. Generalized linear models for ordinal outcomes analyses examined the moderating effect of resting RSA and RSA reactivity (decrease in RSA) on the association between PTSS and maternal sensitivity. The association between maternal PTSS and sensitivity was significantly moderated by resting RSA (  0.03(0.01),  = .033, and RSA reactivity,  0.03(0.01),  = .022.Maternal PTSS was negatively associated with maternal sensitivity only among mothers with higher resting RSA (+1SD above mean),  = -0.05(0.02),  = .030, and with greater RSA reactivity (-1SD below mean RSA reactivity scores),  = -0.06 (0.02),  = 0.021. A tendency toward autonomic overregulation and heightened physiological reactivity may serve as relevant factors influencing how PTSS leads to maladaptive parenting behavior in early postpartum.

We investigated whether neurobehavioral markers of risk for emotion dysregulation were evident among newborns, as well as whether the identified markers were associated with prenatal exposure to maternal emotion dysregulation. Pregnant women (N = 162) reported on their emotion dysregulation prior to a laboratory assessment. The women were then invited to the laboratory to assess baseline respiratory sinus arrhythmia (RSA) and RSA in response to an infant cry. Newborns were assessed after birth via the NICU Network Neurobehavioral Scale. We identified two newborn neurobehavioral factors—arousal and attention—via exploratory factor analysis. Low arousal was characterized by less irritability, excitability, and motor agitation, while low attention was related to a lower threshold for auditory and visual stimulation, less sustained attention, and poorer visual tracking abilities. Pregnant women who reported higher levels of emotion dysregulation had newborns with low arousal levels and less attention. Larger decreases in maternal RSA in response to cry were also related to lower newborn arousal. We provide the first evidence that a woman's emotion dysregulation while pregnant is associated with risks for dysregulation in her newborn. Implications for intergenerational transmission of emotion dysregulation are discussed.

•Cardiorespiratory dynamics significantly impact brain hemodynamics.•Heart rate variability (HRV) and respiratory sinus arrhythmia (RSA) reflect vital physiological states in the brain.•CO2 and O2 levels modulate cerebral blood flow and BOLD signal.•Glymphatic system dynamics influenced by CSF flow can be indirectly detected in fMRI.•Recognizing physiological signals can enhance insights into brain function and health. Cardiorespiratory signals have long been treated as \"noise\" in functional magnetic resonance imaging (fMRI) research, with the goal of minimizing their impact to isolate neural activity. However, there is a growing recognition that these signals, once seen as confounding variables, provide valuable insights into brain function and overall health. This shift reflects the dynamic interaction between the cardiovascular, respiratory, and neural systems, which together support brain activity. In this review, we explore the role of cardiorespiratory dynamics—such as heart rate variability (HRV), respiratory sinus arrhythmia (RSA), and changes in blood flow, oxygenation, and carbon dioxide levels—embedded within fMRI signals. These physiological signals reflect critical aspects of neurovascular coupling and are influenced by factors such as physiological stress, breathing patterns, and age-related changes. We also discuss the complexities of distinguishing these signals from neuronal activity in fMRI data, given their significant contribution to signal variability and interactions with cerebrospinal fluid (CSF). Recognizing the influence of these cardiorespiratory dynamics is crucial for improving the interpretation of fMRI data, shedding light on heart-brain and respiratory-brain connections, and enhancing our understanding of circulation, oxygen delivery, and waste elimination within the brain.