This article describes a study using heart rate variability (HRV) biofeedback to treat emotional dysregulation in 13 individuals with severe chronic brain injury. Measures included HRV indices, tests of attention and problem solving, and informant reports of behavioral regulation. Results demonstrated that individuals with severe brain injury were able to learn HRV biofeedback and increase coherence between the parasympathetic and sympathetic nervous systems. Individuals who attained the greatest coherence were rated as being able to best regulate their emotions and behavior.

Heart rate variability biofeedback: garden game and emotion visualizer. Garden game: The first picture (top row) represents the screen that appears at the start of the session. The last picture represents how the screen is transformed once the individual achieves coherence. Emotion visualizer: The first picture (bottom row) represents the screen that appears at the start of the session. The subsequent pictures represent how the screen is transformed once the individual achieves coherence.

(a) Representative data of heart rhythm pattern changes across time—pretreatment to posttreatment—from a single participant. (b) Heart rate variability recording at pretreatment (T1 and Time 2) and posttreatment (Time 3).

Full-scale attention quotient at Time 3 and low-frequency power/high-frequency power index, the last 5 minutes of the full 10-minute recording taken at Time 3.

A scatter plot depicting improvements in BRIEF-A emotional control informant ratings versus heart rate variability (low-frequency power/high-frequency power 10-minute epoch) improvements across pre- to posttreatment testing.

(a) A scatterplot of scores in Satisfaction With Life Scale and heart rate variability (coherence ratio 10-minute epoch) improvements across pre- to posttreatment. (b) A scatterplot of scores on self-esteem (RSES) and HRV resonance.

Sonya Kim

Rollin McCraty

Vance Zemon

Marie M. Cavallo

Frederick W. Foley
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