Effects of heart rate variability (HRV) biofeedback on HRV and immune response in patients with panic disorder

本研究的目的是分析HRV生物反馈对惊恐障碍(PD)患者的HRV、症状严重程度和细胞因子浓度的影响。焦虑症患者，尤其是PD患者，表现出HRV指数降低(Friedman，2007；Pittig，Arch，Lam，&Craske，2013)。初步结果表明，帕金森病与促炎细胞因子水平升高之间存在关联(Hoge等人，2009年)。先前的研究表明，HRV生物反馈在减少与自主神经失衡相关的精神障碍症状方面是有效的(例如，Karavidas等人，2007；Tan，Dao，Farmer，Sutherland，&Gevirtz，2011)。由于大多数研究在常规治疗的基础上实施了HRV生物反馈，目前还没有人探索HRV生物反馈在多大程度上是一种有效的治疗方法。此外，目前尚不清楚HRV生物反馈是否能够调节细胞因子的产生。数据将在66名帕金森病患者中随机分配到HRV生物反馈或主动控制条件下。被分配到实验组的患者在十周内每周通过一次HRV生物反馈训练。被分配到对照组的患者在两周内每周接受三次积极控制条件的治疗。在最后一次训练后六周的随访中，将再次分析HRV、症状严重程度和细胞因子浓度。这项研究首次测试(1)HRV生物反馈是否在帕金森病的治疗中有效，以及(2)HRV生物反馈是否会正向调节细胞因子的产生。

The aim of the present study is to analyse the effects of HRV biofeedback on HRV, symptom severity and cytokine concentration in patients diagnosed with panic disorder (PD). Patients with anxiety disorders, especially PD patients, exhibit reduced HRV indices (Friedman, 2007; Pittig, Arch, Lam, & Craske, 2013). First results suggest an association between PD and elevated levels of pro-inflammatory cytokines (Hoge et al., 2009). Prior studies showed that HRV biofeedback is effective in reducing symptoms of mental disorders associated with autonomic dysbalance (e. g. Karavidas et al., 2007; Tan, Dao, Farmer, Sutherland, & Gevirtz, 2011). It has not been explored yet to what extent HRV biofeedback alone could be an effective treatment since most studies implemented HRV biofeedback in addition to treatment as usual. Further it is unknown if HRV biofeedback is capable of modulating cytokine production. Data will be obtained in 66 patients with PD randomly assigned to either HRV biofeedback or active control condition. Patients assigned to the experimental group pass one session of HRV biofeedback training per week over ten weeks. Patients assigned to the control group passed three sessions of an active control condition per week over 2 weeks. At follow-.up six weeks after the last training sessions, HRV, symptom severity and cytokine concentration will be analysed again. This study tests for the first time (1) if HRV biofeedback will be effective in the treatment of PD, and (2) if HRV biofeedback will positively modulate cytokine production.