Project Description

A Noninvasive Neurotechnology, HIRREM, Is Associated With Symptom Reduction And Improved Cardiovascular Autonomic Measures In Adolescents With POTS

Neurology April 8, 2014 vol. 82 no. 10 Supplement P7.320 Catherine Tegeler, John Fortunato, Jared Cook, Sung Lee, Meghan Franco and Charles Tegeler.

OBJECTIVE: Assess effect of High-resolution, relational, resonance-based, electroencephalic mirroring (HIRREM) on self-reported autonomic symptoms and cardiovascular measures in POTS.BACKGROUND: Postural orthostatic tachycardia syndrome (POTS) is characterized by heterogeneous symptoms. Pharmacological therapy has limitations. HIRREM is a noninvasive neurotechnology for relaxation and auto-calibration of neural oscillations. Reductions in self-reported symptoms and improvements in heart rate variability (HRV) with HIRREM have been reported.DESIGN/METHODS: Seven adolescents with POTS (age 15-18, 3 males) were enrolled in an IRB-approved open label feasibility study evaluating HIRREM for diverse neuropsychological disorders. Four subjects taking fludrocortisone (FLC) stopped it before or during HIRREM. Subjects rated autonomic symptoms (nausea, vomiting, dizziness, syncope, abdominal pain, constipation, anorexia, fatigue, missing school, flushing, shortness of breath, chest pain, tachycardia, and headaches) from 0 (none) to 4 (severe), before and after a median of 14 (range 10-16) HIRREM sessions (90 minutes each) over 13 (range 8-17) days. Blood pressure and heart rate was continuously recorded and spectral analysis performed for calculating HRV and baroreflex sensitivity (BRS).RESULTS: A trend was observed for reduction in autonomic symptom scores, from median 18 (range 7-34) to 12 (range 3 to 25), p=0.07. Statistically significant improvements were observed in HRV (standard deviation of the R-R interval, SDRR, increased from 51.4 to 73.7, p=0.03) and BRS (HF alpha increased from 25.9 to 39.8, p=0.04). In exploratory analyses, trends were observed for reductions in temporal lobe high frequency electroencephalic asymmetry (23-36 Hertz). No adverse effects were reported. Subjects remained off FLC.CONCLUSIONS: HIRREM was associated with reductions in clinical symptoms of POTS and significant increases in HRV and BRS. HIRREM may have a positive influence in POTS by supporting improved upstream central nervous system regulation of peripheral autonomic dysfunction.

CONCLUSION: Controlled clinical trials of HIRREM are warranted. Study Supported by: The Susanne Marcus Collins Foundation, Inc.