Effect of single session heart rate variability biofeedback on autonomic and cognitive function in patients with opioid use disorder: A pilot study

OUD is characterized by dysregulation of the brain’s reward system, including the mesolimbic dopamine pathway, prefrontal cortex, and amygdala. Its association with maladaptive neuromodulation affecting executive function, emotional regulation, and stress responses, contributes to disease pathophysiological features like craving, relapse and cognitive effects. Studies show positive correlation between stressful life events and high probability of relapse, highlighting the need for stress management techniques that can address the need based acute management of stress at the incidence of high stress life events. Studies have shown that HRV Biofeedback can reduce stress and improve emotional and cognitive functions in healthy subjects.Therefore, the present pilot randomized controlled trial is planned to study the effect of single session HRV Biofeedback training on the autonomic and cognitive function, stress, craving and withdrawal in patients of OUD during early agonist detoxification. The results of the present study can be useful in the determining the role of HRV Biofeedback as an adjunct to the main treatment strategy to support recovery by helping acute management of stressful life events which otherwise are the precipitators of relapse.