Effects of eating together online on autonomic nervous system functions: a randomized, open-label, controlled preliminary study among healthy volunteers.

BACKGROUND: Eating alone has been significantly associated with psychological distress. However, there is no research that evaluates the effects or relation of eating together online to autonomic nervous system functions. METHODS: This is a randomized, open-label, controlled, pilot study conducted among healthy volunteers. Participants were randomized into either an eating together online group or an eating-alone group. The effect of eating together on autonomic nervous functions was evaluated and compared with that of the control (eating alone). The primary endpoint was the change in the standard deviation of the normal-to-normal interval (SDNN) scores among heart rate variabilities (HRV) before and after eating. Physiological synchrony was investigated based on changes in the SDNN scores. RESULTS: A total of 31 women and 25 men (mean age, 36.6 [SD = 9.9] years) were included in the study. In the comparison between the aforementioned groups, two-way analysis of variance revealed interactions between time and group on SDNN scores. SDNN scores in the eating together online group increased in the first and second halves of eating time (F[1,216], P < 0.001 and F[1,216], P = 0.022). Moreover, high correlations were observed in the changes in each pair before and during the first half of eating time as well as before and during the second half of eating time (r = 0.642, P = 0.013 and r = 0.579, P = 0.030). These were statistically significantly higher than those in the eating-alone group (P = 0.005 and P = 0.040). CONCLUSIONS: The experience of eating together online increased HRV during eating. Variations in pairs were correlated and may have induced physiological synchrony. TRIAL REGISTRATION: The University Hospital Medical Information Network Clinical Trials Registry, UMIN000045161. Registered September 1, 2021. https://center6.umin.ac.jp/cgi-open-bin/icdr/ctr_view.cgi?recptno=R000051592 .

Short-term efficacy of home-based heart rate variability biofeedback on sleep disturbance in patients with incurable cancer: a randomised open-label study.

OBJECTIVES: Early palliative care reportedly contributes to the quality of life by improving coping skills in patients with cancer. The aims of the study are to (1) Build a self-coping system that makes it possible to perform a session of home-based heart rate variability biofeedback (HRV-BF) with resonant breathing in patients with sleep disturbance and to acquire its techniques early on, and (2) Examine its short-term efficacy and feasibility. METHODS: A randomised, open-label, comparative study was conducted in the presence or absence of home-based HRV-BF with resonant breathing using a portable HRV-BF device prior to bedtime. The participants were 50 patients with incurable cancer with sleep disturbance who underwent a hospital practice of HRV-BF with resonant breathing. The primary end point was the rate of change in sleep efficiency for 10-14 days. The Japanese version of the Pittsburgh Sleep Quality Index (subjective indicator) and actigraphy sleep parameters (objective indicators) were used for sleep assessments. RESULTS: The completion rate and implementation rate in the home-based HRV-BF group (n=25) were 96.0% and 91.4%, respectively. This group showed a significant improvement in sleep efficiency, sleep duration and the low-frequency component of HRV. Sleep latency worsened in this group, but a significant difference was not observed. CONCLUSIONS: A home practice of HRV-BF with resonant breathing made it possible to acquire its techniques early on and improve sleep and autonomic function; therefore, our study showed high short-term efficacy and feasibility required for a self-coping system.

Relationships between alexisomia and the presence of latent trigger points in the upper trapezius of healthy volunteers.

BACKGROUND: Alexisomia is characterized by difficulties in the awareness and expression of somatic feelings. Trigger points are classified into two types, active and latent, according to the presence or absence of identifying spontaneous pain. OBJECTIVE: We aimed to examine the association between alexisomia and the presence of latent trigger points (LTrPs) in the upper trapezius of healthy volunteers. METHODS: This study was designed as a cross-sectional survey. A correlation analysis between the Shitsu-Taikan-Sho Scale (STSS) and LTrPs was performed on 154 healthy volunteers. The LTrP odds ratio for healthy volunteers with alexisomia was selected as the primary endpoint. RESULTS: LTrPs were seen in the upper trapezius of 82 healthy volunteers (53.2%). There was no significant difference between the LTrP and non-LTrP groups in STSS total score (p= 0.11). However, there was a significant difference between them in STSS difficulty of identifying bodily feelings (DIB) score (p= 0.03). In the alexisomic versus non-alexisomic groups, the LTrP odds ratio for STSS total score was 2.30 (95% confidence interval [CI] 1.03-5.10) and for STSS DIB score, 2.08 (95% CI 1.05-4.11). CONCLUSIONS: In STSS DIB in particular, alexisomia was associated with the presence of LTrP in the upper trapezius of healthy volunteers.

The effect of aerobic exercise on interoception and cognitive function in healthy university students: a non-randomized controlled trial.

BACKGROUND: Interoception refers to the body's physiological responses that occur in response to emotions. This phenomenon influences decision-making, an important cognitive ability that affects the maintenance of an exercise routine. However, it is controversial whether interoception is a reliable measure of an individual's traits or their response to emotion. Given this evidence, we hypothesized that performing an exercise with positive feelings could improve interoception and that the rational decision-making capabilities acquired by improved interoception would, in turn, help in maintaining an exercise routine. Persistent aerobic exercise is essential for improving cognitive and musculoskeletal function in the long term. Therefore, we aimed to investigate changes in interoception during moderate-intensity aerobic exercise at a level that might potentially improve cognitive function. METHODS: We devided 48 healthy university students into an exercise group (n = 37) and a control group (n = 11). The control group did not perform any exercises, while the exercise group performed bench step exercises at an intensity of 50% of heart rate reserve for 30 min a day, three times a week, for three months. We assessed their cognitive function by measuring their auditory information/working memory processing speed using a paced auditory serial addition task (PASAT) and evaluated their interoceptive accuracy (IA) using a heartbeat tracking task at baseline and 1, 2, and 3 months after the start of the exercise intervention. RESULTS: There was a significant positive correlation between IA and PASAT scores at baseline. However, exercise did not lead to a significant increase in PASAT scores of the exercise group as compared with the control group. IA scores increased at 2 and 3 months after the start of exercise only in the exercise group. CONCLUSIONS: This preliminary study showed an improvement in interoception after persistent moderate-intensity aerobic exercise. We believe that exercise-induced improvement of interoception may facilitate exercise maintenance through improved cognitive function. Statistical analysis did not explain the non-uniformity of sample sizes, therefore, future studies should have larger sample sizes with equal subjects in each group to allow for better comparability and generalizability. TRIAL REGISTRATION: UMIN, UMIN000042891. 04/01/2021, retrospectively registered.

Interoception and alexithymia are related to differences between the self-reported and the objectively measured physical activity in patients with chronic musculoskeletal pain.

OBJECTIVE: Patients with chronic musculoskeletal pain (CMP) have difficulty estimating their level of physical activity (PA). Factors associated with this difficulty have yet to be identified; however, identification could allow for increased accuracy in large-scale PA surveys, and enhanced self-management. The purpose of this study was to determine the relationship of interoception and alexithymia with differences between self-reported and objectively measured PA, and investigate factors as they relate to accurately self-reporting PA. METHODS: A cross-sectional survey of 33 patients with CMP and 32 healthy individuals was conducted from July 2018 to June 2019. We measured differences in Moderate to Vigorous Physical Activity (D-MVPA) using an accelerometer and self-report. A heartbeat tracking task (HTT) was used to measure interoception, and alexithymia was measured using the 20-item Toronto Alexithymia Scale (TAS-20). RESULTS: The CMP group (median 43.5 min/day, IQR 20.6-77.6) showed significantly higher D-MVPA values than the control group (median 22.5 min/day, IQR 6.7-34.9) (p < .001). In patients with CMP, D-MVPA positively correlated with TAS-20 (rho = 0.470, p = .006) and correlated negatively with HTT (rho = -0.390, p = .025). CONCLUSION: Inaccurate self-reported measurements of PA in patients with CMP are associated with alexithymia and interoception. This finding suggests that behavioral interventions targeting alexithymia and interoception in CMP patients could lead to improved self-monitoring.

Factors associated with chronic thoracic spine and low back pain in caregivers of cancer patients.

BACKGROUND: Caregiving for people with cancer can cause chronic back pain (CBP) in family caregivers, but little is known about the associated caregiving-related factors. The study aim was to examine relationship between pain location and the factors related to care of cancer patients by family caregivers. METHODS: A cross-sectional survey was conducted among 320 family caregivers of advanced cancer patients from 2016 to 2018 at a single-unit university hospital. CBP locations were categorized as thoracic spine and lower back, and achievement of pain improvement goals defined as pain intensity (PI) ≤ personalized pain goal (PPG). Cancer caregiving-related factors were examined using a self-report questionnaire measuring subjective psychological stresses in family caregivers: depression, anxiety, insomnia, and caregiver burden. Medical records were used to determine patients' cancer severity based on performance status and time from survey until death. Multivariate logistic regression analysis was conducted. The dependent variable was presence of thoracic spine/low back pain; the independent variables were care recipient performance status and duration from survey until death, and caregiver scores on the Hospital Anxiety and Depression ScaleDepression, Hospital Anxiety and Depression Scale-Anxiety, Pittsburgh Sleep Quality Index-J, and Zarit Caregiver Burden Interview-J. RESULTS: In total, 31.4% of family caregivers had chronic thoracic spine pain and 28.3% chronic lower back pain. Of these, 60.0% of those with thoracic spine pain and 46.7% of those with lower back pain achieved their pain improvement goal. Logistic regression analysis showed that depression score was associated with chronic thoracic spine pain (both PI ≤ PPGs and PI > PPGs) (P=0.001 and P=0.027) and sleep score with chronic thoracic spine pain (PI > PPGs) (P=0.018). Performance status and time from survey until death were associated with chronic lower back pain (PI > PPGs) (P=0.034 and P=0.017). CONCLUSIONS: Our results suggest that the factors related to caregiving in cancer patients differ according to back pain location. To reduce CBP, it is important to address subjective psychological stress and physical burden with reference to back pain location.