Key result
Biofeedback training using either self-alert training or progressive muscle relaxation successfully altered autonomic nervous system activity but had no effect on fatigue status or vigilance performance.
Why the study?
MS-related fatigue may be linked to autonomic nervous system dysfunction or inflammation-related vagal activation, suggesting that modulating autonomic status could potentially relieve fatigue.
Does biofeedback-based training alleviate fatigue and improve vigilance performance in fatigued MS patients?
RCT
Does biofeedback-based training alleviate fatigue and improve vigilance performance in fatigued MS patients?
Biofeedback training successfully altered autonomic nervous system activity in MS patients but did not translate to improvements in fatigue or vigilance performance.
Answers are grounded in this paper and cite their sources.
Biofeedback does not improve fatigue or vigilance in MS; leaves open whether ANS modulation can affect symptoms in larger trials.
MS related fatigue might be related to autonomous nervous system (ANS) dysfunctions or to inflammation related vagal (hyper-) activation. Consequently, influencing ANS status may lead to relieve of fatigue. We used two opposite biofeedback interventions to either increase sympathetic (“self-alert training”, SAT) or parasympathetic activation (“progressive muscle relaxation”, PMR). We recorded fatigue status of patients before and after a challenging vigilance task, their behavioural performance on this task, their skin conductance response (SCR), and parameters indicating parasympathetic activity concerning heart rate variability (HRV). We repeated these recordings after the biofeedback training sessions. Patients of the SAT group were able to learn to increase their SCR voluntarily. Patients of the PMR group showed increasing parameters indicating parasympathetic modulation of the HRV. The vigilance task increased their feeling of fatigue. However, there was no effect of biofeedback training on either fatigue status or performance on the vigilance task. Our results show that MS patients can learn to change voluntarily their ANS activity using biofeedback instructions based on SCR and this can be used in future studies to test the postulated link between ANS and fatigue. However, in this experimental intervention we were unable to document a relation between ANS activity and fatigue.Trial registration: ClinicalTrials.gov identifier: NCT03268187.
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Sander et al. (2020) conducted an RCT in Multiple Sclerosis (MS) related fatigue. Biofeedback training (self-alert training or progressive muscle relaxation) vs. Opposite biofeedback intervention was evaluated on Fatigue status and performance on a vigilance task. Biofeedback training using either self-alert training or progressive muscle relaxation successfully altered autonomic nervous system activity but had no effect on fatigue status or vigilance performance.
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