Coherent breathing based biofeedback training and its effects on the interaction of autonomic nervous system activity, cellular immune activation and depressive symptoms in adults. An intervention study.


INTRODUCTION: Major depressive disorder (MDD) is a highly prevalent illness, estimated being the second leading cause of disability by the year 2020. Considering the obvious insufficiency of the current, primarily pharmaceutical oriented treatment paradigm, manifesting itself in high rates of recurrence, side effects and treatment resistance among those affected by this disease, new treatment options are warranted.

Vagus nerve stimulation (VNS) seems to be a possible alternative, as both, artificial and natural ways of VNS have shown promising results in treating MDD. Coherent breathing (CB) is a natural method to stimulate the vagus nerve, with the advantage of being non-invasive compared to for example, electrical VNS. CB is based on the phenomenon that a certain breathing frequency creates resonance in the central nervous system, manifesting itself in higher vagal activity. Although seemingly effective, the ways of action through which VNS ́s effects on MDD are mediated remain relatively unclear.

OBJECTIVE: Considering the emerging evidence of low-grade inflammation fueling the depressive fire, seemingly lower vagal activity in depressed individuals and VNS having potential antiinflammtory properties, this work tries to elucidate the question whether CB can attenuate the systemic low-grade inflammation in depressed individuals and if the latter mediates the effect of vagus nerve activity on the magnitude of depressive symptoms.

METHOD: 92 inpatients of a psychiatric rehabilitation program with depression were randomly assigned to either an intervention or a waitlist control group, with the former receiving six 35 minute long, guided breathing sessions over a period of 5 weeks in addition to the standard rehabilitation-protocol, supported by a portable biofeedback device (Qiu) to help participants train at their individual resonance breathing frequency and thus maximizing vagal activity during training sessions. Additionally, the experimental group was asked to practice CB individually with the Qiu, twice daily for 10 minutes. All participants filled out the Beck-Depression-Inventory II, Beck-Anxiety-Inventory- II, completed a 3-minute short term heart rate variability (HRV) and a 1-minute paced breathing HRV recording before and after the 5-week study period. As a validated marker of inflammation, neopterin was measured from participants urine at three time points, namely twice before and once after the intervention period. Results are still pending and will be reported.


J.M. Tatschl1, D. Fuchs2, S. Deller3 & A. Schwerdtfeger1

1 Divison of Health Psychology, Department of Psychology, Karl-Franzens-University Graz

2 Division of Biological Chemistry, Biocenter, Medical University of Innsbruck

3 Division of Endocrinology and Diabetology, Core Facility „Clinical research Center“, Medical University of Graz


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