Brain–heart interplay modulation during biofeedback: A new frontier in understanding self-regulation

INTRODUCTION: The intricate communication between the brain and the inner body significantly impacts human behavior, with disruptions in this dialog potentially leading to decreased self-regulation and higher risk of depression, anxiety, and cognitive impairment. The present study tested Brain-Heart Interplay (BHI) indexes during a voluntary self-regulation task involving biofeedback of heart rate (HR-BF). METHODS: Forty-five healthy students underwent a single session of HR-BF in which they were required to modulate their cardiac activity by increasing or decreasing HR relative to baseline, with or without visual feedback, while an electroencephalogram and electrocardiogram were co-registered to calculate BHI indexes. RESULTS: Participants performed better at increasing versus decreasing HR (p< .001), and in presence of feedback, in respect to absence of feedback (p = .005). During HR decrease, higher brain-to-HRV coupling in theta and alpha frequency bands emerged (p