Applied Psychophysiology and Biofeedback

, Volume 31, Issue 3, pp 203–216 | Cite as

Thermal Biofeedback for Primary Raynaud’s Phenomenon: A Review of the Literature

  • Maria Katsamanis Karavidas
  • Pei-Shan Tsai
  • Carolyn Yucha
  • Angele McGrady
  • Paul M. Lehrer
Article

The clinical presentation of primary Raynaud’s phenomenon (RP) derives from various pathogenic triggers. The use of thermal biofeedback (TBF) may be of benefit in reducing the severity and frequency of attacks. This article summarizes the relevant research regarding the pathophysiology of primary RP and mechanism of TBF for RP. Systematic reviews of the efficacy of TBF for RP and treatment guidelines for clinicians are provided. The panel concludes that the level of evidence for TBF efficacy is categorized as Level IV: efficacious. The rationale, based on three randomized controlled trials conducted in independent laboratories, demonstrated “superiority or equivalence” of treatments that include TBF. However, randomly controlled trials (RCT) with positive clinical outcomes tended to be small. A large RCT with negative results did not effectively teach handwarming skills. Procedures for reviewing and rating of the levels of evidence of efficacy of studies was based on the Template for Developing Guidelines for the Evaluation of the Clinical Efficacy of Psychophysiological Interventions developed by the joint task force of the AAPB and the Society for Neuronal Regulation (SNR).

KEY WORDS

Thermal biofeedback Primary Raynaud’s phenomenon 

REFERENCES

  1. Allen, E. V., & Brown, G. E. (1932). Raynaud’s disease: a critical review of minimal requisites for diagnosis. American Journal of Medical Science, 183, 187–200.Google Scholar
  2. Block, J. A., & Sequeira, W. (2001). Raynaud’s phenomenon. The Lancet, 357, 2042–2048.CrossRefGoogle Scholar
  3. Cattell, R. B. (1957). IPAT anxiety scale. Institute for Personality and Ability Testing, Champaign, IL.Google Scholar
  4. Coffman, J. D. (1991). Raynaud’s phenomenon. Hypertension, 17, 593–602.PubMedGoogle Scholar
  5. Freedman, R. R., & Ianni, P. (1983). Role of cold and emotional stress in Raynaud’s disease and scleroderma. British Medical Journal, 287, 1499–1502.PubMedGoogle Scholar
  6. Freedman, R. R., Ianni, P., & Wenig, P. (1985). Behavioral treatment of Raynaud’s disease: Long-term follow-up. Journal of Consulting and Clinical Psychology, 53, 136.PubMedCrossRefGoogle Scholar
  7. Freedman, R. R., Sabharwal, S. G., Ianni, P., Desai, N., Wenig, P., & Mayes, M. (1988). Nonneural beta-adrenergic vasodilating mechanism in temperature biofeedback. Psychosomatic Medicine, 50, 394–401.PubMedGoogle Scholar
  8. Freedman, R. R., Moten, M., Migaly, P., & Mayes, M. (1993). Cold-induced potentiation of a2-adrenergic vasoconstriction in idiopathic Raynaud’s disease. Arthritis and Rheumatism, 36, 685–690.PubMedGoogle Scholar
  9. Gardner-Medwin, J. M., Macdonald, I. A., Taylor, J. Y., Riley, P. H., & Powell, R. J. (2001). Seasonal differences in finger skin temperature and microvascular blood flow in healthy men and women are exaggerated in women with primary Raynaud’s phenomenon. British journal of Clinical Pharmacology, 52, 17–23.PubMedCrossRefGoogle Scholar
  10. Graafsma, S. J., Wollersheim, H., Droste, H. T., ten Dam, M. A. G. J., van Tits, L. J. H., Reyenga, J., de Miranda, J. F. R., & Thien, T. (1991). Adrenoreceptors on blood cells from patients with primary Raynaud’s phenomenon. Clinical Science, 80, 325–331.PubMedGoogle Scholar
  11. Guglielmi, R. S., Roberts, A. H., & Patterson, R. (1982). Skin temperature biofeedback for Raynaud’s disease: A double-blind study. Biofeedback and Self-Regulation, 7, 99–120.PubMedCrossRefGoogle Scholar
  12. Jacobson, A. M., Manschreck, T. C., & Silverberg, E. (1979). Behavioral treatment for Raynaud’s disease: A comparative study with long-term follow-up. American Journal of Psychiatry, 136, 844–846.PubMedGoogle Scholar
  13. Jennings, J. R., Maricq, H. R., Canner, J., Thompson, B., Freedman, R. R., Wise, R., et al. (1999). A thermal vascular test for distinguishing between patients with Raynaud’s phenomenon and healthy controls. Raynaud’s Treatment Study Investigators. Health Psychology, 18, 421–426.PubMedCrossRefGoogle Scholar
  14. Jobe, J. B., Sampson, J. B., Roberts, D. E., & Kelly, J. A. (1986). Comparison of behavioral treatment for Raynaud’s disease. Journal of Behavioral Medicine, 9, 89–96.PubMedCrossRefGoogle Scholar
  15. Keefe, F. J., Surwit, R. S., & Pilon, R. N. (1979). A 1-year follow-up of Raynaud’s patients treated with behavioral therapy techniques. Journal of Behavioral Medicine, 2, 385–391.PubMedCrossRefGoogle Scholar
  16. Keefe, F. J., Surwit, R. S., & Pilon, R. N. (1980). Biofeedback, autogenic training, and progressive relaxation in the treatment of Raynaud’s disease: A comparative study. Journal of Applied Behavior Analysis, 13, 3–11.PubMedCrossRefGoogle Scholar
  17. La Vaque, T. J., Corrydon, H., Trudeau, D., Monastra, V., Perry, J., Lehrer, P., et al. (2002). Template for developing guidelines for the evaluation of the clinical efficacy of psychophysiological interventions. Applied Psychophysiology and Biofeedback, 27(4), 273–281.CrossRefGoogle Scholar
  18. LeRoy, E. C., & Medsger, T. A. (1992). Raynaud’s phenomenon: A proposal for classification. Clinical and Experimental Rheumatology, 10, 485–488.PubMedGoogle Scholar
  19. Maricq, H. R., Jennings, J. R., Valter, I., Frederick, M., Thompson, B., Smith, E. A., et al. (2000). Evaluation of treatment efficacy of Raynaud phenomenon by digital blood pressure response to cooling. Raynaud’s Treatment Study Investigators. Vascular Medicine, 5, 135–140.PubMedCrossRefGoogle Scholar
  20. Maricq, H. R., Valter, I., & Maricq, J. G. (1998). An objective method to estimate the severity of Raynaud phenomenon: Digital blood pressure response to cooling. Vascular Medicine, 3, 109–113.PubMedCrossRefGoogle Scholar
  21. Middaugh, S. J., Haythornthwaite, J. A., Thompson, B., Hill, R., Brown, K. M., Freedman, R. R., et al. (2001). The Raynaud’s treatment study: Biofeedback protocols and acquisition of temperature biofeedback skills. Applied Psychophysiology and Biofeedback, 26, 251–278.PubMedCrossRefGoogle Scholar
  22. Raynaud’s Treatment Study (RTS) Investigators. (2000). Comparison of sustained-release nifedipine and temperature biofeedback for treatment of primary Raynaud phenomenon. Archives of Internal Medicine, 160, 1101–1108.CrossRefGoogle Scholar
  23. Robinson, M. E., Gagnon, C. M., Riley, J. L., & Price, D. D. (2003). Altering gender role expectations: effects on pain tolerance, pain threshold, and pain ratings. Journal of Pain, 4, 284–288.PubMedCrossRefGoogle Scholar
  24. Schwartz, M. S., & Sedlacek, K. (2003). Raynaud’s disease: selected issues and considerations in using biofeedback therapies. In M. S. Schwartz, & F. Andrasik (Eds.), Biofeedback: a practitioner’s guide (3rd ed.). (pp. 369–381). NY: The Guilford Press.Google Scholar
  25. Sedlacek, K. (1979). Biofeedback for Raynaud’s disease. Psychosomatics, 20, 535–541.PubMedGoogle Scholar
  26. Sedlacek, K., & Taub, E. (1996). Biofeedback treatment of Raynaud’s disease. Professional Psychology: Research and Practice, 27, 548–553.CrossRefGoogle Scholar
  27. Simlan, A., Holligan, S., Brennan, P., & Maddison, P. (1990). Prevalence of symptoms of Raynaud’s phenomenon in general practice. British Medical Journal, 301, 590–592.CrossRefGoogle Scholar
  28. Surwit, R. S., Pilon, R. N., & Fenton, C. H. (1978). Behavioral treatment of Raynaud’s disease. Journal of Behavioral Medicine, 1, 323–335.PubMedCrossRefGoogle Scholar
  29. Taub, E., & School, P. J. (1978). Some methodological considerations in thermal biofeedback training. Behavior Research Methods and Instrumentation, 10(5), 617–622.Google Scholar
  30. Taub, E., & Stroebel, C. F. (1978). Biofeedback in the treatment of vasoconstrictive syndromes. Biofeedback and Self Regulation, 3(4), 363–373.PubMedCrossRefGoogle Scholar
  31. Thompson, B., Geller, N. L., Hunsberger, S., Frederick, M., Hill, R., Jacob, R. G., et al. (1999). Behavioral and pharmacological interventions: The Raynaud’s treatment study. Controlled Clinical Trials, 20, 52–63.PubMedCrossRefGoogle Scholar
  32. Turton, E. P. L., Kent, P. J., & Kester, R. C. (1998). The etiology of Raynaud’s phenomenon. Cardiovascular Surgery, 6, 431–440.PubMedCrossRefGoogle Scholar
  33. Weinrich, M. C., Maricq, H. R., Keil, J. E., McGregor, A. R., & Diat, F. (1990). Prevalence of Raynaud’s phenomenon in the adult population of South Carolina. Journal of Clinical Epidemiology, 43, 1343–1349.PubMedCrossRefGoogle Scholar
  34. Wigley, F. M. (2002). Raynaud’s phenomenon. New England Journal Medicine, 347, 1001CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Maria Katsamanis Karavidas
    • 1
    • 5
  • Pei-Shan Tsai
    • 2
  • Carolyn Yucha
    • 3
  • Angele McGrady
    • 4
  • Paul M. Lehrer
    • 1
  1. 1.University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical SchoolPiscatawayUSA
  2. 2.Taipei Medical UniversityTaipeiTaiwan
  3. 3.University of NevadaLas VegasUSA
  4. 4.Medical College of OhioToledoUSA
  5. 5.University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical SchoolPiscatawayUSA

Personalised recommendations