title: A pilot study of the efficacy of heart rate variability (HRV) biofeedback in patients with fibromyalgia.
abstract: Fibromyalgia (FM) is a non-inflammatory rheumatologic disorder characterized by musculoskeletal pain, fatigue, depression, cognitive dysfunction and sleep disturbance. Research suggests that autonomic dysfunction may account for some of the symptomatology of FM. An open label trial of biofeedback training was conducted to manipulate suboptimal heart rate variability (HRV), a key marker of autonomic dysfunction.
  
  
  METHODS
  Twelve women ages 18-60 with FM completed 10 weekly sessions of HRV biofeedback. They were taught to breathe at their resonant frequency (RF) and asked to practice twice daily. At sessions 1, 10 and 3-month follow-up, physiological and questionnaire data were collected.
  
  
  RESULTS
  There were clinically significant decreases in depression and pain and improvement in functioning from Session 1 to a 3-month follow-up. For depression, the improvement occurred by Session 10. HRV and blood pressure variability (BPV) increased during biofeedback tasks. HRV increased from Sessions 1-10, while BPV decreased from Session 1 to the 3 month follow-up.
  
  
  CONCLUSIONS
  These data suggest that HRV biofeedback may be a useful treatment for FM, perhaps mediated by autonomic changes. While HRV effects were immediate, blood pressure, baroreflex, and therapeutic effects were delayed. This is consistent with data on the relationship among stress, HPA axis activity, and brain function.
authors.affiliation: Department of Medicine, Division of Rheumatology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School (UMDNJ-RWJMS), P.O. Box 19, MEB-484, New Brunswick, NJ, USA. a.hassett@umdnj.edu
authors.forename: Afton L
authors.initials: AL
authors.lastname: Hassett
authors.forename: Diane C
authors.initials: DC
authors.lastname: Radvanski
authors.forename: Evgeny G
authors.initials: EG
authors.lastname: Vaschillo
authors.forename: Bronya
authors.initials: B
authors.lastname: Vaschillo
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Sigal
authors.forename: Maria Katsamanis
authors.initials: MK
authors.lastname: Karavidas
authors.forename: Steven
authors.initials: S
authors.lastname: Buyske
authors.forename: Paul M
authors.initials: PM
authors.lastname: Lehrer
mesh_terms: D000293:Adolescent; D000328:Adult; D001143:Arousal / Q000502:physiology; D001341:Autonomic Nervous System / Q000503:physiopathology; D001676:Biofeedback, Psychology / Q000502:physiology*; D003863:Depression / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology / Q000628:therapy*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D012803:Sick Role; D016896:Treatment Outcome