Heart-brain medicine: Update 2009
STRATEGIES FOR MODULATING HEART-BRAIN INTERACTIONS
In line with the need for more effective strategies to modulate heart-brain interactions, the summit went on to review and discuss the role of biofeedback. If the effects of depression, post-traumatic stress disorder, and other psychological modulators of vagal tone are the mechanism of action for adverse outcomes in these patient populations, then methods to directly modulate vagal tone may prove efficacious.15 Within the Bakken Heart-Brain Institute we recently committed half a million dollars to fund a biofeedback program. The program’s goal is to investigate the efficacy of biofeedback in improving outcomes within and across several states of cardiovascular disease and chronic disease. We believe that rigorous and standardized delivery and quantification of the effects of biofeedback are critical in order to robustly determine the role of biofeedback in the treatment of patients with chronic disease.
The group of experts assembled at this year’s summit presented further evidence of the potential importance of biofeedback for the control and treatment of multiple disorders, including heart failure, epilepsy, and chronic headache. As the mechanisms underlying brain interactions with end-organ innervations and systemic inflammation are dissected, it is clear that this field of medicine will have greater impact on the outcomes of many patient populations.
CROSS-FERTILIZATION OF TREATMENT APPROACHES
The summit abounded with evidence and examples of how neurology, cardiology, and psychiatry continue to cross-fertilize one another and foster interdisciplinary innovation. We were fortunate to have Brian Litt, MD, from the University of Pennsylvania return for the 2009 summit to update us on the progress of detecting, mapping, and extinguishing early seizure activity before there is clinical evidence of a seizure. The lessons learned and clinical advancement of internal cardiac defibrillators offer insights and great hope for this potentially important advancement in the treatment of seizure disorders. Similarly, Irving Zucker, PhD, from the University of Nebraska reviewed how neuromodulation through the baroreceptors can be targeted to modulate arterial blood pressure. Clearly there is great potential for device-based therapies to augment the treatment of chronic hypertension and improve outcomes in clinical populations at risk.
A LOOK AHEAD
Many of the topics reviewed above are discussed in detail in the proceedings supplement that follows. We continue to be excited and gratified by the progress being made in the field of heart-brain medicine. The continuing commitment to the rigorous multidisciplinary approach that has served this field well to date will continue to advance our understanding of disease and improve outcomes in our patients. We hope you will join us September 23–24, 2010, at the Lou Ruvo Center for Brain Health in Las Vegas, Nevada, for the 2010 Heart-Brain Summit, our fifth annual gathering.
