About this Research Topic

Background

The development and dissemination of non-pharmacological and non-invasive interventions to support physical and mental health are high priorities in the behavioral health arena. For example, Heart rate variability (HRV) biofeedback and resonance paced breathing have shown particular promise, and a growing literature supports the effectiveness of interventions that modulate HRV and baroreflex sensitivity in treating physical disorders such as asthma and hypertension, as well as psychiatric conditions.

Provocative laboratory and clinical evidence supports such interventions for regulating affect and arousal in substance use disorders, affective disorders, and post-traumatic stress disorder (PTSD). The idea of affecting ‘neuromodulation’ by relatively simple manipulations of respiratory rate is elegant in its simplicity and accessibility. The time is ripe to transition this niche area of research and application to the mainstream.

Clinical research on HRV and underlying neurocardiac mechanisms of action is exploding across the globe. Yet, work in different laboratories remains fragmented, diminishing progress in translating the most promising findings to address addictive disorders and other mental health problems. Given that these problems contribute substantially to the global disease burden and this burden is increasing over time, there is great need to scale up new, effective and accessible preventive interventions and treatments, as well as tools to sustain holistic health promotion and recovery. Further, technological advancements such as wearable biosensors and smart phone apps now offer new tools that have the capacity to scale up. Yet, here too there is limited consensus on how and for whom these tools will be most effective. This research topic focuses on the heart-brain interactions that support arousal modulation, emotion regulation, and behavioral flexibility, with a special emphasis on mechanisms of action and implications for the use of HRV biofeedback and resonance breathing as adjunctive treatments for addiction and prevalent co-occurring affective disorders. Better understanding of integrated cardiovascular and neural system processes as potential mechanisms of behavior change offers innovative intervention approaches and targets. Our hope is that this collected research topic will provide a springboard for new collaborations and partnerships among laboratories world-wide to facilitate international research programs and training to address the global burden of disorders characterized by difficulty regulating affect and arousal.

This cross-cutting research topic in Frontiers in Psychiatry and co-listed in Frontiers in Behavioral Neuroscience, Frontiers in Psychology, and Frontiers in Cardiovascular Medicine invites the global HRV research community to submit original basic and clinical science research as well as systematic and meta-analytic reviews describing current work on HRV biofeedback and resonance paced breathing, and mechanisms of action in addictive and co-occurring affective disorders with the following priority areas:

• Clinical trials of HRV biofeedback, resonance paced breathing, and other neurocardiac interventions as adjuvants to treatment-as-usual in disorders characterized by difficulty regulating affect and arousal including addictive disorders, anxiety and depressive disorders, bipolar disorder, and PTSD
• Basic human research on integrated cardiovascular and neural system processes as mechanisms of action with implications for treatment process, outcome, and sustained recovery
• Research on the relation of HRV to key features of addictive behaviors such as craving, incentive salience, and negative affect
• Integrative neuroimaging studies of cardiovascular and neural system response with implications for the prevention or treatment
• Research on the relation of HRV, HRV biofeedback, and resonance paced breathing to emotion regulation in addictive disorders, anxiety and depressive disorders, bipolar disorder, and PTSD
• Research in high risk populations (e.g., binge drinkers) that informs understanding of mechanisms of behavior change, or preventive applications of neurocardiac interventions
• Methodological and technological advancements with clear applied relevance to clinical science that could increase the accessibility and scalability (e.g., e-Health) of neurocardiac interventions
• Applications to underserved and diverse populations
• Pre-clinical animal models that inform the above topics

Keywords: Heart Rate Variability Biofeedback, Resonance Paced Breathing, Neuromodulation, Addiction, Affective disorders

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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