Advanced Medical Scientist-Programm 2023

Thema: "The relation of autonomic dysfunction and Post-COVID Fatigue: effect of autonomic biofeedback training"

Zusammenfassung:
More than 60% of people surviving COVID-19 infection suffer from persistent symptoms. When those symptoms last for at least 2 months in a period starting 3 months after the infection the term post-COVID-19 condition is used. Post-COVID-19 occurs in approximately 10%-14% of people infected, affecting over 5 million people. Debilitating fatigue is the most persistent and most prevalent symptom after COVID-19. As there is no established therapy, there is urgent need for research on potential interventions in patients with post-COVID-19 fatigue (PCF).
Excessive fatigue is generally accompanied by autonomic dysregulation that is characterized by sympathetic over-activation and withdrawal of parasympathetic influence on the heart. It has been suggested that autonomic dysfunction contributes to persistent fatigue by impairing cerebral blood flow. Thus, a training with a focus on enhancing cardiac parasympathetic control seems to be promising.
Our previous work suggests that HRV biofeedback increases parasympathetic modulation of heart rate and enhances prefrontal inhibitory control over limbic regions in the brain. These cortical structures play an important role in central regulation of cardiac activity but are also key regions in the so-called ‘fatigue network’. A functional brain network that was recently proposed. In patients with chronic fatigue syndrome, biofeedback of heart rate variability (HRV) has already been demonstrated to decrease fatigue levels. In this research proposal, we want to investigate the effect of HRV biofeedback on cardiac autonomic
regulation, fatigue levels and fronto-limbic connectivity in PCF patients. We hypothesize that an HRV increase after biofeedback will be accompanied by decreased subjective fatigue ratings. Data acquired in an inactive control group and a treatment-as-usual group will be used for comparison.