Using Heart Rate Variability/Vagal Tone Increase Biofeedback Training to Improve Emotional & Cognitive Function in Women with Breast Cancer Diagnosis

患有乳腺癌（BC）的女性患有严重的慢性情感脆弱性和认知缺陷，严重影响她们的生活质量和预期寿命。证据有力地表明，这些缺陷与自主神经系统（ANS）功能障碍有关，这些功能障碍是由乳腺癌的普通治疗直接引起的。越来越多的研究强调了ANS功能障碍（即持续交感神经分支过度激活）在积极肿瘤治疗后对癌症幸存者健康造成严重不良情绪和身体影响的潜在作用。目前的治疗方法既没有针对ANS失衡，也没有充分解决乳腺癌人群中复杂、严重的情绪和认知症状合并症。慢呼吸技术，特别是以每分钟约6次呼吸的共振频率呼吸，已知可以直接刺激ANS的副交感神经分支，改善身体健康以及情绪和认知功能。因此，本研究的主要目的是评估非侵入性、可获得的心率变异性（HRV）生物反馈训练干预的长期疗效，包括有节奏的呼吸，这已被证明直接影响ANS活动/平衡，即心脏迷走神经张力的改善（增加副交感神经活动和相关的交感神经抑制），显示出在人群中心理和身体健康结果的显着改善。我的研究将利用新的非侵入性HRV生物反馈实践工具来提高女性乳腺癌幸存者的情绪和认知弹性。本研究将结合高精度生理（HRV）测量和行为学方法，并采用自我报告和先进的定量测量方法，研究生物反馈训练对情绪调节和认知控制测量的影响。本研究将收集定性数据，并使用框架方法对潜在的精神病理（情感和认知）进行全面检查。这是一种可靠的方法，将用于分析HRV生物反馈训练对BC幸存者中与ANS功能障碍相关的健康和生活质量指标的影响，包括睡眠、疼痛、情绪、疲劳、压力、静息心率变异性和心率。任何与治疗相关的变化以及心理和身体症状之间的相互作用都将随时间进行测量和深入检查。这将有助于将心理/体验现象的背景化，有助于理解癌症的个人生活经历以及心理和身体症状，从而为未来的康复和HRV增加生物反馈干预（即共振频率呼吸）的最佳应用提供见解。这项研究完全符合对新的互补性、可获得的干预措施的需求，也符合对现有低强度操作（如呼吸技术）进行系统研究的呼吁，以提供对改善公共卫生结果的循证干预措施的机制理解。

Women with a breast cancer (BC) diagnosis suffer profound and chronic emotional vulnerability with cognitive deficits which severely impact on their quality of life and life expectancy. Evidence strongly suggests that these deficits are linked to autonomic nervous system (ANS) dysfunction caused directly by common treatments for breast cancer. Accumulating research emphasises the underlying role of the ANS dysfunction (i.e., sustained sympathetic branch overactivation) in causing severe adverse emotional and physical effects on cancer survivors' health post active oncologic treatment. Current therapeutic approaches do not target the ANS imbalance nor do they sufficiently address the complex, severe comorbidity of emotional and cognitive symptoms in the breast cancer population. Slow breathing techniques, especially breathing at the resonance frequency of ~ 6 breaths per minute, are known to directly stimulate the parasympathetic branch of the ANS improving physical health as well as emotional and cognitive functioning. The primary aim of this research is therefore, to assess the long-term efficacy of a non-invasive, accessible Heart Rate Variability (HRV) biofeedback training intervention, involving paced breathing, which has been shown to directly influence ANS activity/balance, i.e., improvement in cardiac vagal tone (increase parasympathetic activity, and associated sympathetic inhibition) showing significant improvements in psychological and physical health outcomes across populations. My research will utilise the novel non-invasive HRV biofeedback practice tool to improve emotional and cognitive resilience in female breast cancer survivors. The research will combine high precision physiological (HRV measures), behavioural methods and use self-report and advanced quantitative measures to study the biofeedback training effects on measures of emotion regulation and cognitive control. The study will collect qualitative data and use the Framework Method for a comprehensive examination of underlying psychopathology (emotional and cognitive). This is a robust method will be used to analyse the impact of HRV biofeedback training on the health and quality of life indices associated with ANS dysfunction in BC survivors including sleep, pain, mood, fatigue, stress, resting heart rate variability and heart rate. Any treatment-related changes and interactions between psychological and physical symptoms will be measured across time and examined in depth. This will help to contextualise the psychological/experiential phenomena, help make sense of individual lived experience of cancer and psychological and physical symptoms to provide insights into future rehabilitation and optimal application of the HRV increase biofeedback intervention (i.e., resonance frequency breathing). This research falls firmly in line with demands for new complementary, accessible interventions as well as calls for systematic research into existing low intensity manipulations such as breathing techniques, to provide a mechanistic understanding of evidence-based interventions improving public health outcomes.