Peak High-Frequency HRV and Peak Alpha Frequency Higher in PTSD
- 1.5k Downloads
Posttraumatic stress disorder (PTSD) is difficult to treat and current PTSD treatments are not effective for all people. Despite limited evidence for its efficacy, some clinicians have implemented biofeedback for PTSD treatment. As a first step in constructing an effective biofeedback treatment program, we assessed respiration, electroencephalography (EEG) and heart rate variability (HRV) as potential biofeedback parameters for a future clinical trial. This cross-sectional study included 86 veterans; 59 with and 27 without PTSD. Data were collected on EEG measures, HRV, and respiration rate during an attentive resting state. Measures were analyzed to assess sensitivity to PTSD status and the relationship to PTSD symptoms. Peak alpha frequency was higher in the PTSD group (F(1,84) = 6.14, p = 0.01). Peak high-frequency HRV was lower in the PTSD group (F(2,78) = 26.5, p < 0.00005) when adjusting for respiration rate. All other EEG and HRV measures and respiration were not different between groups. Peak high-frequency HRV and peak alpha frequency are sensitive to PTSD status and may be potential biofeedback parameters for future PTSD clinical trials.
KeywordsPosttraumatic stress disorder Combat veterans Heart rate variability Peak alpha frequency Biofeedback
This work was supported in part by National Institute of Health grants T32AT002688, K01AT004951, U19AT002656, UL1RR024140, K24AT005121, and a Tartar Trust Grant. Special thanks to Roger Ellingson, Irina Fonareva, Jennifer Bishop and Elena Goodrich for their assistance with this study.
Conflict of interest
The authors have no conflicts of interest to disclose.
- American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Publishing Inc.Google Scholar
- Baehr, E., Rosenfeld, J. P., Baehr, R., & Earnest, C. (1999). Clinical use of an alpha asymmetry neurofeedback in the treatment of mood disorders. In A. Abarbanel & J. R. Evans (Eds.), Introduction to quantitative EEG and neurofeedback (pp. 181–201). Massachusetts: Academic Press.CrossRefGoogle Scholar
- Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory -Second Edition Manual. San Antonio: Harcourt Brace & Company.Google Scholar
- Berg, A. O., Breslau, N., Goodman, S. N., Lezak, M. D., Matchar, D. B., Mellman, T. A., et al. (2007). Treatment of PTSD: An assessment of the evidence. Washington, DC: National Academies Press.Google Scholar
- Department of Veteran Affairs and Department of Defense. (2010). VA/DoD clinical practice guideline for the management of post-traumatic stress. Washington, DC: Veterans Health Administration, Department of Veteran Affairs, Department of Defense.Google Scholar
- First, M., Spitzer, R., Gibbon, M., & Williams, J. (2002). Structured clinical interview for DSM-IV-TR Axis 1 disorders-patient edition (SCID-I/P, 11/2002 revision). New York, New York: Biometrics Research Department.Google Scholar
- Grunert, B. K., Weis, J. M., Smucker, M. R., & Christianson, H. F. (2007). Imagery rescripting and reprocessing therapy after failed prolonged exposure for post-traumatic stress disorder following industrial injury. Journal of Behavior Therapy and Experimental Psychiatry, 38(4), 317–328.PubMedCrossRefGoogle Scholar
- Hammond, D. C. (2005). Neurofeedback with anxiety and affective disorders. Child and Adolescent Psychiatric Clinics of North America, 14(1), 105–123, vii.Google Scholar
- Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6, 65–70.Google Scholar
- Kemp, A. H., Griffiths, K., Felmingham, K. L., Shankman, S. A., Drinkenburg, W., Arns, M., et al. (2010). Disorder specificity despite comorbidity: Resting EEG alpha asymmetry in major depressive disorder and post-traumatic stress disorder. Biological Psychology, 85(2), 350–354. doi: 10.1016/j.biopsycho.2010.08.001.PubMedCrossRefGoogle Scholar
- Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617–627. doi: 10.1001/archpsyc.62.6.617.PubMedCrossRefGoogle Scholar
- Olgin, J., & Zipes, D. (2007). Specific arrhythmias: Diagnosis and treatment. In P. Libby, R. Bonow, D. Mann, & D. Zipes (Eds.), Braunwald’s heart disease: A textbook of cardiovascular medicine. St. Louis, Mo: WB Saunders.Google Scholar
- Peniston, E. G., & Kulkosky, P. J. (1991). Alpha-theta brainwave neuro-feedback therapy for Vietnam veterans with combat-related post-traumatic stress disorder. Medical Psychotherapy, 4, 47–60.Google Scholar
- Ramchand, R., Schell, T. L., Karney, B. R., Osilla, K. C., Burns, R. M., & Caldarone, L. B. (2010). Disparate prevalence estimates of PTSD among service members who served in Iraq and Afghanistan: Possible explanations. Journal of Traumatic Stress, 23(1), 59–68. doi: 10.1002/jts.20486.PubMedGoogle Scholar
- Seal, K. H., Cohen, G., Waldrop, A., Cohen, B., Maguen, S., & Ren, L. (2011). Substance use disorders in Iraq and Afghanistan veterans in VA healthcare, 2001-2010: Implications for screening, diagnosis and treatment. Drug Alcohol Depend, 2011 Jan 28 [Epub ahead of print].Google Scholar
- Whitham, E. M., Pope, K. J., Fitzgibbon, S. P., Lewis, T., Clark, C. R., Loveless, S., et al. (2007). Scalp electrical recording during paralysis: Quantitative evidence that EEG frequencies above 20 Hz are contaminated by EMG. Clinical Neurophysiology, 118(8), 1877–1888. doi: 10.1016/j.clinph.2007.04.027.PubMedCrossRefGoogle Scholar
- Zucker, T. L., Samuelson, K. W., Muench, F., Greenberg, M. A., & Gevirtz, R. N. (2009). The effects of respiratory sinus arrhythmia biofeedback on heart rate variability and posttraumatic stress disorder symptoms: A pilot study. Association for Applied Psychophysiology and Biofeedback, 34(2), 135–143. doi: 10.1007/s10484-009-9085-2.CrossRefGoogle Scholar