Use of an allostatic neurotechnology by adolescents with postural orthostatic tachycardia syndrome (POTS) is associated with improvements in heart rate variability and changes in temporal lobe electrical activity

Abstract

Autonomic dysregulation and heterogeneous symptoms characterize postural orthostatic tachycardia syndrome (POTS). This study evaluated the effect of high-resolution, relational, resonance-based, electroencephalic mirroring (HIRREM®), a noninvasive, allostatic neurotechnology for relaxation and auto-calibration of neural oscillations, on heart rate variability, brain asymmetry, and autonomic symptoms, in adolescents with POTS. Seven subjects with POTS (three males, ages 15–18) underwent a median of 14 (10–16) HIRREM sessions over 13 (8–17) days. Autonomic function was assessed from 10-min continuous heart rate and blood pressure recordings, pre- and post-HIRREM. One-minute epochs of temporal high-frequency (23–36 Hz) brain electrical activity data (T3 and T4, eyes closed) were analyzed from baseline HIRREM assessment and subsequent sessions. Subjects rated autonomic symptoms before and after HIRREM. Four of seven were on fludrocortisone, which was stopped before or during their sessions. Heart rate variability in the time domain (standard deviation of the beat-to-beat interval) increased post-HIRREM (mean increase 51 %, range 10–143, p = 0.03), as did baroreflex sensitivity (mean increase in high-frequency alpha 65 %, range −6 to 180, p = 0.05). Baseline temporal electrical asymmetry negatively correlated with change in asymmetry from assessment to the final HIRREM session (p = 0.01). Summed high-frequency amplitudes at left and right temporal lobes decreased a median of 3.8 μV (p = 0.02). There was a trend for improvements in self-reported symptoms related to the autonomic nervous system. Use of HIRREM was associated with reduced sympathetic bias in autonomic cardiovascular regulation, greater symmetry and reduced amplitudes in temporal lobe high-frequency electrical activity, and a trend for reduced autonomic symptoms. Data suggest the potential for allostatic neurotechnology to facilitate increased flexibility in autonomic cardiovascular regulation, possibly through more balanced activity at regions of the neocortex responsible for autonomic management.Clinical trial registry “Tilt Table with Suspected postural orthostatic tachycardia syndrome (POTS) Subjects,” Protocol Record: WFUBAHA01.

Clinical, hemispheric, and autonomic changes associated with use of closed-loop, allostatic neurotechnology by a case series of individuals with self-reported symptoms of post-traumatic stress

“…The present findings are consistent with earlier studies reporting reductions in temporal lobe high frequency asymmetry, improvements in heart rate variability, or both, in the course of allostatic neurotechnology usage by adults with insomnia [41], adolescents with postural orthostatic tachycardia syndrome (POTS; [42]), and athletes with persisting post-concussion symptoms [43]. Other neurotechnologies proposed for treatment of PTSD include stimulatory techniques such as transcranial magnetic stimulation (TMS; [44]) and transcranial direct current stimulation (TDCS; [45]), which are open-loop approaches in that they do not record brain activity before delivering successive cycles of their intervention.…”

Functional Brain Network Changes Following Use of an Allostatic, Closed‐Loop, Acoustic Stimulation Neurotechnology for Military‐Related Traumatic Stress

“…17,45 The allostatic strategy is to go upstream to the source of pathogenesis, to facilitate adaptive variability of set points across subsystems downstream. Studies have also indicated that this allostatic neurotechnology may be therapeutic for postural orthostatic tachycardia syndrome, 46 sport-related concussion, 47 and other conditions. 18,48 Several features or limitations of this study should be noted.…”

Successful use of closed-loop allostatic neurotechnology for post-traumatic stress symptoms in military personnel: self-reported and autonomic improvements

“…Recordings with dropped beats or gross motion artifacts are excluded from analysis. Assessments included multiple measures of heartrate variability (HRV) in both time and frequency domains, baroreflex sensitivity (BRS), and blood pressure [ 42 ].…”