Higher Vagal Activity as Related to Survival in Patients With Advanced Breast Cancer

Giese‐Davis, Janine; Wilhelm, Frank H.; Tamagawa, Rie; Palesh, Oxana; Neri, Eric; Taylor, C. Barr; Kraemer, Helena C.; Spiegel, David

doi:10.1097/psy.0000000000000167

Cited by 80 publications

(66 citation statements)

References 103 publications

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“…Unilateral cervical vagotomy has been shown to promote lung, liver, kidney and adrenal metastases in experimental 4THMpc breast carcinoma, suggesting a tonic protective effect of the vagus nerve against metastatic disease in this context [171,172]. In line with these observations, higher baseline high frequency of heart rate variability, which is indicative for higher vagal tone is associated with significantly longer survival of patients with metastatic and recurrent breast cancer [173]. Bilateral subdiaphragmatic vagotomy promotes the development of experimental carcinogen-induced pancreatic [174] and gastric cancer [175,176].…”

Section: Neurocircuitry and Inflammation In Obesity And Cancermentioning

confidence: 94%

Neural circuitry and immunity

2015

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Research during the last decade has significantly advanced our understanding of the molecular mechanisms at the interface between the nervous system and the immune system. Insight into bidirectional neuroimmune communication has characterized the nervous system as an important partner of the immune system in the regulation of inflammation. Neuronal pathways, including the vagus nerve-based inflammatory reflex are physiological regulators of immune function and inflammation. In parallel, neuronal function is altered in conditions characterized by immune dysregulation and inflammation. Here, we review these regulatory mechanisms and describe the neural circuitry modulating immunity. Understanding these mechanisms reveals possibilities to use targeted neuromodulation as a therapeutic approach for inflammatory and autoimmune disorders. These findings and current clinical exploration of neuromodulation in the treatment of inflammatory diseases defines the emerging field of Bioelectronic Medicine.

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Section: Neurocircuitry and Inflammation In Obesity And Cancermentioning

confidence: 94%

Neural circuitry and immunity

2015

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“…Both low HRV and higher heart rate are predictors of shorter survival in metastatic breast cancer and are risk factors for cardiovascular disease 101–103 . BRS reflects the ability of the baroreflex to regulate acute changes in BP by adjusting heart rate.…”

Section: Methodsmentioning

confidence: 99%

Protocol for the MATCH study (Mindfulness and Tai Chi for cancer health): A preference-based multi-site randomized comparative effectiveness trial (CET) of Mindfulness-Based Cancer Recovery (MBCR) vs. Tai Chi/Qigong (TCQ) for cancer survivors

Carlson

Zelinski

Speca

et al. 2017

Contemporary Clinical Trials

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Purpose A growing number of cancer survivors suffer high levels of distress, depression and stress, as well as sleep disturbance, pain and fatigue. Two different mind-body interventions helpful for treating these problems are Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong (TCQ). However, while both interventions show efficacy compared to usual care, they have never been evaluated in the same study or directly compared. This study will be the first to incorporate innovative design features including patient choice while evaluating two interventions to treat distressed cancer survivors. It will also allow for secondary analyses of which program best targets specific symptoms in particular groups of survivors, based on preferences and baseline characteristics. Methods and Significance The design is a preference-based multi-site randomized comparative effectiveness trial. Participants (N = 600) with a preference for either MBCR or TCQ will receive their preferred intervention; while those without a preference will be randomized into either intervention. Further, within the preference and non-preference groups, participants will be randomized into immediate intervention or wait-list control. Total mood disturbance on the Profile of Mood States (POMS) post-intervention is the primary outcome. Other measures taken pre- and post-intervention and at 6-month follow-up include quality of life, psychological functioning, cancer-related symptoms and physical functioning. Exploratory analyses investigate biomarkers (cortisol, cytokines, blood pressure/heart rate variability, telomere length, gene expression), which may uncover potentially important effects on key biological regulatory and antineoplastic functions. Health economic measures will determine potential savings to the health system.

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“…Indeed, this biomarker has shown clinical value in hypertensive patients to predict fallers (Melillo et al, 2015) and in cancer patients (Palesh et al, 2008; Giese-Davis et al, 2015). …”

Section: The Circadian Timing System and Its Multilevel Intersubjmentioning

confidence: 99%

Systems Chronotherapeutics

et al. 2017

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Chronotherapeutics aim at treating illnesses according to the endogenous biologic rhythms, which moderate xenobiotic metabolism and cellular drug response. The molecular clocks present in individual cells involve approximately fifteen clock genes interconnected in regulatory feedback loops. They are coordinated by the suprachiasmatic nuclei, a hypothalamic pacemaker, which also adjusts the circadian rhythms to environmental cycles. As a result, many mechanisms of diseases and drug effects are controlled by the circadian timing system. Thus, the tolerability of nearly 500 medications varies by up to fivefold according to circadian scheduling, both in experimental models and/or patients. Moreover, treatment itself disrupted, maintained, or improved the circadian timing system as a function of drug timing. Improved patient outcomes on circadian-based treatments (chronotherapy) have been demonstrated in randomized clinical trials, especially for cancer and inflammatory diseases. However, recent technological advances have highlighted large interpatient differences in circadian functions resulting in significant variability in chronotherapy response. Such findings advocate for the advancement of personalized chronotherapeutics through interdisciplinary systems approaches. Thus, the combination of mathematical, statistical, technological, experimental, and clinical expertise is now shaping the development of dedicated devices and diagnostic and delivery algorithms enabling treatment individualization. In particular, multiscale systems chronopharmacology approaches currently combine mathematical modeling based on cellular and whole-body physiology to preclinical and clinical investigations toward the design of patient-tailored chronotherapies. We review recent systems research works aiming to the individualization of disease treatment, with emphasis on both cancer management and circadian timing system–resetting strategies for improving chronic disease control and patient outcomes.

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Higher Vagal Activity as Related to Survival in Patients With Advanced Breast Cancer

Cited by 80 publications

References 103 publications

Neural circuitry and immunity

Neural circuitry and immunity

Protocol for the MATCH study (Mindfulness and Tai Chi for cancer health): A preference-based multi-site randomized comparative effectiveness trial (CET) of Mindfulness-Based Cancer Recovery (MBCR) vs. Tai Chi/Qigong (TCQ) for cancer survivors

Systems Chronotherapeutics

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