The production of the film was supported by the Emili Sagol Creative Arts Therapies Research Center.

This study was conducted with the approval of the Faculty of Social Welfare &#38; Health Sciences at the University of Haifa, ethics committee. Informed consent was obtained, and research was performed in compliance with Helsinki guidelines for human welfare.
NOTE: The research is conducted at a table, using art materials and a portable, wireless and non-invasive electrocardiogram (ECG) recording device.
1. Participant selection
<ol>
	<li>Recruit healthy participants between the ages of 18 and 40. For a wider range of ages, a division to sub-groups is recommended due to age related changes in heart rate variability.</li>
	<li>Exclude participants with current or a history of heart disease as heart disease can affect heart rate variability, thus limiting the ability to examine whether change is due to the behavioral activity.</li>
	<li>Invite all subjects to the laboratory between 08:00-15:00, to ensure similar conditions. Set any time frame as long as the experiment can be conducted within it.</li>
	<li>Greet the participant and confirm that in the 2 hours before the experiment the participant did not drink coffee, eat, smoke or vigorously exercise.</li>
	<li>Obtain written informed consent to ensure that participants know they are free to leave the experiment at any point in time without consequence and are aware of any risks and benefits to participation.</li>
</ol>
2. Experimental protocol
<ol>
	<li>Adhere the biopatch two fingers below the sternum with 2 Ag-AgCl disposable electrodes. The ECG is sampled (1000 Hz, 16 bit) and recorded with the biopatch.</li>
	<li>Examine that the values of the data collected (i.e., heart rate, HRV) appear on the graphic interface ensuring that data is being collected. The software will also transmit an audio alarm when the biopatch goes offline.</li>
	<li>After the participant adapts to the environment and wears the biopatch, measure 5 min of resting heart rate in a sitting position to establish baseline HRV. Instruct the participant to sit still, and avoid chewing or talking, which affects the HRV.</li>
	<li>Following the 5 min rest to establish baseline HRV, instruct participants to fill out pencil and paper questionnaires with demographic data, a question about art making habits and the self-assessment manikin (SAM)5. Instruct participants to mark the drawing that is closest to how they feel at the current moment (See Figure 2).</li>
	<li>To establish a comparable emotional state, have participants listen to 5 min of relaxing music of their choice (nature sounds, new age or classical music) before each artmaking session. The relaxing music is purposely chosen by the participant to ensure that it is relaxing for them6.</li>
	<li>Provide participants with a (50 cm x 35 cm) sheet of paper and instruct them to engage in a 10 min artmaking session (pencil, oil pastels or gouache paint). To reduce an order affect, randomize the order of the art materials. 
	NOTE: Here, after drawing with pencil, the participants used oil pastels and then gouache paint.
	<ol>
		<li>Encourage participants to engage in an exploration of the materials in any way they feel fit and use the entire 10 min for artmaking. Provide encouragement by reminding participants that the art product and its aesthetics are not important and that they can draw anything at all.</li>
		<li>Present the pencil with a pencil sharpener and an eraser.</li>
		<li>Instruct participants to report their emotional state using the SAM.</li>
	</ol>
	</li>
	<li>Turn on music and instruct participants to listen to 5 min of relaxing music of their choice (nature sounds, new age or classical music).</li>
	<li>Place an open box of 12 colors of oil pastels on the table and instruct participants to use them in any way they choose including peeling the wrapper and breaking the pastel if needed.
	<ol>
		<li>Replace the box of pastels for the next subject if their general appearance is significantly affected by use.</li>
		<li>Instruct participants to report their emotional state using the SAM.</li>
	</ol>
	</li>
	<li>Turn on music and instruct participants to listen to 5 min of relaxing music of their choice (nature sounds, new age or classical music).</li>
	<li>Present gouache paint in primary colors (yellow, red and blue), black and white in a plastic palette, divided into 6 bowls and 4 mixing surfaces, to control the quantities of paint. In addition, provide a jar of water, a soft, flat-headed brush (size 6) and a cloth.
	<ol>
		<li>Tell the subjects that they can request additional paint if needed.</li>
		<li>Provide a short explanation of mixing colors and cleaning the brushes.</li>
		<li>Instruct participants to report their emotional state using the SAM.</li>
	</ol>
	</li>
	<li>Remove the biopatch from the participant at the end of the session. Download the data recorded with the biopatch to the computer using the biopatch download log.</li>
</ol>
3. Data analysis
<ol>
	<li>Convert the data to a text file that is appropriate for import to the visual analysis software (e.g., QRSTool)7, saving only the time stamp and voltage vectors, using a MATLAB script. The MATLAB script* is helpful in saving the timestamp and voltage vectors, while erasing the rest. This can be done manually but is very time consuming. The resulting text file example is presented in Figure 3.</li>
	<li>Import the text file created by the MATLAB script to the QRSTool using the graphical user interface: File | Import | (Choose File). Make sure that the sample rate 1000 Hz button is pressed. The ECG will then be graphically displayed in the window of QRSTool.</li>
	<li>Visually inspect the ECG series for artefacts. Identify the R component of the ECG using the QRS-tool software (See Figure 4). The software automatically detects the R spikes, by flagging all points with a red hourglass, above a threshold marked manually. 
	NOTE: For more information contact the third author at: jallen@email.arizona.edu
	<ol>
		<li>Visually inspect each ECG series alongside the identified heartbeats, time points and artefacts (missed or wrongfully identified heartbeats), which may have an excessive or missing heartbeat in the inter-beat intervals graph. Correct this manually by clicking to remove the extra heartbeat or adding one where missing.</li>
		<li>In areas of data with noise, not showing an identifiable QRS waveform, divide the data into several chunks, of 30 seconds at least. 
		NOTE: Remember, tails of cropped data cannot be added together. Analyze these separately and create a mean of all chunks.</li>
		<li>Mark or divide the data according to various phases of the experiment. To do so, use the visual interface to cut off and save only the data for each event and export them separately to CMetX (described below). Divide the data based on the experiment stages described above (baseline, music listening and art making with the various materials).</li>
	</ol>
	</li>
	<li>When all data is clean, export to CMETX by using the visual interface File | Export, or directly by a command line. This will open the CMetX viewer window with an added line with the indices of HRV.</li>
	<li>Export HRV indices to a CSV file for data analysis
	<ol>
		<li>Use two indices of HRV: the estimated respiratory sinus arrythmia (RSA) as a vagal or parasympathetic index and the cardiac sympathetic index (CSI) &#8211; based on a Lorenz plot that estimates sympathetic influence. Figure 4 is an example of the output provided by the CMetX software. 
		NOTE: Choosing the appropriate HRV index to represent vagal or sympathetic cardiac regulation can be tricky and requires some methodologically and theoretically based decisions that are beyond the scope of this presentation. For further information we recommend reading: Allen, J. J., Chambers, A. S., &#38; Towers, D. N. (2007). The many metrics of cardiac chronotropy: A pragmatic primer and a brief comparison of metrics8.</li>
	</ol>
	</li>
	<li>Estimate HRV reactivity by subtracting the mean HRV index during music listening from the mean HRV index during the following artmaking session (i.e., positive values represent higher HRV during artmaking compared to the proceeding relaxation).</li>
</ol>

<ol><li>Kagin, S. L., Lusebrink, V. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((The+expressive+therapies+continuum%5BTitle%5D)+AND+%22Art+Psychotherapy%22%5BJournal%5D)">The expressive therapies continuum.</a> Art Psychotherapy. 5 (4), 171-180 (1978).</li>
<li>Butler, E. A., Wilhelm, F. H., Gross, J. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Respiratory+sinus+arrhythmia%2C+emotion%2C+and+emotion+regulation+during+social+interaction%5BTitle%5D)+AND+%22Psychophysiology%22%5BJournal%5D)">Respiratory sinus arrhythmia, emotion, and emotion regulation during social interaction.</a> Psychophysiology. 43 (6), 612-622 (2006).</li>
<li>Balzarotti, S., Biassoni, F., Colombo, B., Ciceri, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Cardiac+vagal+control+as+a+marker+of+emotion+regulation+in+healthy+adults%3A+A+review%5BTitle%5D)+AND+%22Biological+Psychology%22%5BJournal%5D)">Cardiac vagal control as a marker of emotion regulation in healthy adults: A review.</a> Biological Psychology. 130, 54-66 (2017).</li>
<li>Kaimal, G., Ray, K., Muniz, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Reduction+of+Cortisol+Levels+and+Participants%27+Responses+Following+Art+Making%5BTitle%5D)+AND+%22Art+Therapy%22%5BJournal%5D)">Reduction of Cortisol Levels and Participants' Responses Following Art Making.</a> Art Therapy. 33 (2), 74-80 (2016).</li>
<li>Bradley, M. M., Lang, P. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Measuring+emotion%3A+the+self-assessment+manikin+and+the+semantic+differential%5BTitle%5D)+AND+%22Journal+of+Behavior+Therapy+and+Experimental+Psychiatry%22%5BJournal%5D)">Measuring emotion: the self-assessment manikin and the semantic differential.</a> Journal of Behavior Therapy and Experimental Psychiatry. 25 (1), 49-59 (1994).</li>
<li>Jiang, J., Rickson, D., Jiang, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((The+mechanism+of+music+for+reducing+psychological+stress%3A+Music+preference+as+a+mediator%5BTitle%5D)+AND+%22The+Arts+in+Psychotherapy%22%5BJournal%5D)">The mechanism of music for reducing psychological stress: Music preference as a mediator.</a> The Arts in Psychotherapy. 48, 62-68 (2016).</li>
<li>Haiblum-Itskovitch, S., Czamanski-Cohen, J., Galili, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Emotional+response+and+changes+in+heart+rate+variability+following+art-making+with+three+different+art+materials%5BTitle%5D)+AND+%22Frontiers+in+Psychology%22%5BJournal%5D)">Emotional response and changes in heart rate variability following art-making with three different art materials.</a> Frontiers in Psychology. 9, (2018).</li>
<li>Allen, J. J., Chambers, A. S., Towers, D. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((The+many+metrics+of+cardiac+chronotropy%3A+a+pragmatic+primer+and+a+brief+comparison+of+metrics%5BTitle%5D)+AND+%22Biological+Psychology%22%5BJournal%5D)">The many metrics of cardiac chronotropy: a pragmatic primer and a brief comparison of metrics.</a> Biological Psychology. 74 (2), 243-262 (2007).</li>
<li>Johnstone, J. A., Ford, P. A., Hughes, G., Watson, T., Garrett, A. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((BioHarness%E2%84%A2+multivariable+monitoring+device%3A+part.+I%3A+validity%5BTitle%5D)+AND+%22Journal+of+Sports+Science+%26+Medicine%22%5BJournal%5D)">BioHarness™ multivariable monitoring device: part. I: validity.</a> Journal of Sports Science & Medicine. 11 (3), 400(2012).</li>
<li>Johnstone, J. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Field+Based+Reliability+and+Validity+of+the+Bioharness%E2%84%A2+Multivariable+Monitoring+Device%5BTitle%5D)+AND+%22Journal+of+Sports+Science+%26+Medicine%22%5BJournal%5D)">Field Based Reliability and Validity of the Bioharness™ Multivariable Monitoring Device.</a> Journal of Sports Science & Medicine. 11 (4), 643-652 (2012).</li>
</ol>

The authors have nothing to disclose.

This protocol is designed to measure differences in RSA during artmaking with art materials varying in their levels of fluidity7. The biopatch9,10 is a small round physiological monitoring telemetry device that attaches to a holster that connects to two Ag-AgCl disposable electrodes and enables the collection of physiological data, including basic ECG. The device stores and transmits vital sign data including ECG, heart rate, respiration r...

The purpose of this protocol is to examine the physiological and emotional response to artmaking in different conditions. In this case, the difference in response to art making with three different art materials varying in levels of fluidity is examined. The rationale behind the development of this experiment is to provide support for theories of art therapy claiming that artmaking with more fluid art materials is related to enhancing emotional expression1. Heart rate variability (HRV) in general, and respiratory sinus arrythmia (RSA) specifically, is indicative of emotional engagement and regulation2,3. In this study example, the order of the art materials used are randomized to control for an order effect. There are no other studies with this study design found.
The advantage of this method is that the ongoing measurement of heart rate variability (HRV) enables the examination of the physiological response to artmaking during the art making itself and it is noninvasive. This is in opposition to measuring bio-markers in blood or saliva following art making, which is important and relevant, but can be challenging to time accurately and requires uncomfortable (drooling in to a tube) or invasive (providing a blood sample) collection methods4.
This protocol can be adapted to measure response to a variety of behavioral activities, and art making with different materials. To do so, replace the artmaking with three materials with the desired behaviors to be examined. It is important to make sure that most elements of the behaviors being examined are similar other than the quality of the behavior being examined (i.e., the liquidity of the art material). Figure 1 is a flow chart of the experiment.

<table><tbody><tr><td>Disposable Ag/AgCl electrodes</td><td>Biopac</td><td>EL501</td><td></td></tr><tr><td>Drawing paper</td><td>Stenoplast</td><td></td><td></td></tr><tr><td>Echo gateway</td><td>Medtronic</td><td>9600.0303</td><td></td></tr><tr><td>Eraser</td><td>Factis</td><td></td><td></td></tr><tr><td>Gouache paint</td><td>Giotto</td><td></td><td></td></tr><tr><td>HB pencil</td><td>Milan</td><td></td><td></td></tr><tr><td>Omnisense 3.9.7</td><td>Medtronic</td><td>9700.0269</td><td>Computer software</td></tr><tr><td>Oil pastels 12 colors</td><td>Talens</td><td></td><td></td></tr><tr><td>Zephyr biopatch</td><td>Medtronic</td><td>9600.041</td><td></td></tr></tbody></table>

examining changes in hrv and emotion following artmaking with three different art materials

This protocol enables the examination of psychological and physiological responses to different types of behavioral engagements. Specifically, in this study example, the emotional response and changes in heart rate variability are examined in response to artmaking with three different art materials that vary in their levels of fluidity. This protocol can be adapted to examine other types of behavior or engagement in artmaking with other materials. There are several benefits to using this protocol. Firstly, the order randomization of the materials improves the probability that the response measured is associated with its qualities and not the order of presentation. Secondly, the continuous measuring of electrocardiogram enables the examination of changes in heart rate variability after engagement with each art material and changes that might occur during the artmaking itself. The advantages of this protocol should be considered with their limitations. The music listening is before each art making session; thus, the return to baseline can only be measured in the first two conditions. The return to baseline provides information on how fast individuals recover after response to working with each of the materials. Furthermore, a more liquid material instead of gouache paint with a brush, such as finger paints, provides more difference between materials. Finally, this protocol can be adapted to specific research needs.

As mentioned above, the CMetX software provides several matrices of HRV. Here, the RSA measure, was calculated for each participant per each experimental condition. Figure 5 depicts mean RSA values (&#177;SE) for the three artmaking tasks and their preceding resting periods. A within subjects ANOVA revealed a statistically significant main effect for artmaking (F(1,49) = 26.155, p &#60; .001), with a large effect size (&#951;p2 = .348), whic...

Watch this Scientific Journal Video about Examining Changes in HRV and Emotion Following Artmaking with Three Different Art Materials at JoVE.com

Examining Changes in HRV and Emotion Following Artmaking with Three Different Art Materials

The goal of the protocol is to guide researchers in conducting experiments that are intended to measure changes in self-reported emotional response and heart rate variability following art making with different materials. The protocol can easily be adapted for use in a variety of behavioral conditions and activities.

This protocol enables the examination of psychological and physiological responses to different types of behavioral engagements. Specifically, in this ...

examining-changes-hrv-emotion-following-artmaking-with-three

Research

JoVE Journal

Behavior

6.0K Views.  University of Haifa. The goal of the protocol is to guide researchers in conducting experiments that are intended to measure changes in self-reported emotional response and heart rate variability following art making with different materials. The protocol can easily be adapted for use in a variety of behavioral conditions and activities.

Video: Examining Changes in HRV and Emotion Following Artmaking with Three Different Art Materials

Brain Imaging Investigation of the Neural Correlates of Emotion Regulation

The ability to control/regulate emotions is an important coping mechanism in the face of emotionally stressful situations. Although significant progress has been made in understanding conscious/deliberate emotion regulation (ER), less is known about non-conscious/automatic ER and the associated neural correlates. This is in part due to the problems inherent in the unitary concepts of automatic and conscious processing1. Here, we present a protocol that allows investigation of the neural correlates of both deliberate and automatic ER using functional magnetic resonance imaging (fMRI). This protocol allows new avenues of inquiry into various aspects of ER. For instance, the experimental design allows manipulation of the goal to regulate emotion (conscious vs. non-conscious), as well as the intensity of the emotional challenge (high vs. low). Moreover, it allows investigation of both immediate (emotion perception) and long-term effects (emotional memory) of ER strategies on emotion processing. Therefore, this protocol may contribute to better understanding of the neural mechanisms of emotion regulation in healthy behaviour, and to gaining insight into possible causes of deficits in depression and anxiety disorders in which emotion dysregulation is often among the core debilitating features.

We present a protocol that allows investigation of the neural correlates of deliberate and automatic emotion regulation, using functional magnetic resonance imaging. This protocol can be used in healthy participants, both young and older, as well as in clinical patients.

The ability to control/regulate emotions is an important coping mechanism in the face of emotionally stressful situations. Although significant progress ...

Neuroscience

Brain Imaging Investigation of the Memory-Enhancing Effect of Emotion

Emotional events tend to be better remembered than non-emotional events1,2. One goal of cognitive and affective neuroscientists is 
to understand the neural mechanisms underlying this enhancing effect of emotion on memory. A method that has proven particularly influential in the 
investigation of the memory-enhancing effect of emotion is the so-called subsequent memory paradigm (SMP). This method was originally used to investigate the 
neural correlates of non-emotional memories3, and more recently we and others also applied it successfully to studies of emotional memory (reviewed in4, 5-7). 
Here, we describe a protocol that allows investigation of the neural correlates of the memory-enhancing effect of emotion using the SMP in conjunction with 
event-related functional magnetic resonance imaging (fMRI). An important feature of the SMP is that it allows separation of brain activity specifically 
associated with memory from more general activity associated with perception. Moreover, in the context of investigating the impact of emotional stimuli, 
SMP allows identification of brain regions whose activity is susceptible to emotional modulation of both general/perceptual and memory-specific processing. 
This protocol can be used in healthy subjects8-15, as well as in clinical patients where there are alterations in the neural correlates of emotion perception 
and biases in remembering emotional events, such as those suffering from depression and post-traumatic stress disorder (PTSD)16, 17.

We present a protocol that uses functional magnetic resonance imaging to investigate the neural correlates of the memory-enhancing effect of emotion. This protocol allows identification of brain activity specifically linked to memory-related processing, contrary to more general perceptual processing, and can be used with healthy and clinical populations.

Emotional events tend to be better remembered than non-emotional events1,2. One goal of cognitive and affective neuroscientists is 
to understand the ...

Brain Imaging Investigation of the Impairing Effect of Emotion on Cognition

Emotions can impact cognition by exerting both enhancing (e.g., better memory for emotional events) and impairing (e.g., increased emotional distractibility) effects (reviewed in 1). Complementing our recent protocol 2 describing a method that allows investigation of the neural correlates of the memory-enhancing effect of emotion (see also 1, 3-5), here we present a protocol that allows investigation of the neural correlates of the detrimental impact of emotion on cognition. The main feature of this method is that it allows identification of reciprocal modulations between activity in a ventral neural system, involved in 'hot' emotion processing (HotEmo system), and a dorsal system, involved in higher-level 'cold' cognitive/executive processing (ColdEx system), which are linked to cognitive performance and to individual variations in behavior (reviewed in 1). Since its initial introduction 6, this design has proven particularly versatile and influential in the elucidation of various aspects concerning the neural correlates of the detrimental impact of emotional distraction on cognition, with a focus on working memory (WM), and of coping with such distraction 7,11, in both healthy 8-11 and clinical participants 12-14.

We present a protocol that allows investigation of the neural mechanisms mediating the detrimental impact of emotion on cognition, using functional magnetic resonance imaging. This protocol can be used with both healthy and clinical participants.

Emotions can impact cognition by exerting both enhancing (e.g., better memory for emotional events) and impairing (e.g., increased emotional ...

Psychophysiological Assessment of the Effectiveness of Emotion Regulation Strategies in Childhood

Effective regulation of emotion is one of the most important skills that develops in childhood. Research interest in this area is expanding, but empirical work has been limited by predominantly correlational investigations of children's skills. Relatedly, a key conceptual challenge for emotion scientists is to distinguish between emotion responding and emotion regulatory processes. This paper presents a novel method to address these conceptual and methodological issues in child samples. An experimental paradigm that assesses the effectiveness with which children regulate emotion is described. Children are randomly assigned to use specific emotion regulation strategies, negative emotions are elicited with film clips, and changes in subsequent psychophysiology index the extent to which emotion regulation is effective. Children are instructed to simply watch the emotion-eliciting film (control), distract themselves from negative emotions (cognitive distraction), or reframe the situation in a way that downplays the importance of the emotional event (cognitive reappraisal). Cardiac physiology, continuously acquired before and during the emotional task, serves as an objective measure of children's unfolding emotional responding while viewing evocative films. Key comparisons in patterns of obtained physiological reactivity are between the control and emotion regulation strategy conditions. Representative results from this approach are described, and discussion focuses on the contribution of this methodological approach to developmental science.

A detailed protocol for an experimental paradigm to assess the effectiveness with which children regulate emotion is described. Children are randomly assigned to use specific emotion regulation strategies, negative emotions are elicited with film clips, and changes in subsequent psychophysiology index the extent to which emotion regulation is effective.

Effective regulation of emotion is one of the most important skills that develops in childhood. Research interest in this area is expanding, but empirical ...

Using Wavelet Entropy to Demonstrate how Mindfulness Practice Increases Coordination between Irregular Cerebral and Cardiac Activities

In both the East and West, traditional teachings say that the mind and heart are somehow closely correlated, especially during spiritual practice. One difficulty in proving this objectively is that the natures of brain and heart activities are quite different. In this paper, we propose a methodology that uses wavelet entropy to measure the chaotic levels of both electroencephalogram (EEG) and electrocardiogram (ECG) data and show how this may be used to explore the potential coordination between the mind and heart under different experimental conditions. Furthermore, Statistical Parametric Mapping (SPM) was used to identify the brain regions in which the EEG wavelet entropy was the most affected by the experimental conditions. As an illustration, the EEG and ECG were recorded under two different conditions (normal rest and mindful breathing) at the beginning of an 8-week standard Mindfulness-based Stress Reduction (MBSR) training course (pretest) and after the course (posttest). Using the proposed method, the results consistently showed that the wavelet entropy of the brain EEG decreased during the MBSR mindful breathing state as compared to that during the closed-eye resting state. Similarly, a lower wavelet entropy of heartrate was found during MBSR mindful breathing. However, no difference in wavelet entropy during MBSR mindful breathing was found between the pretest and posttest. No correlation was observed between the entropy of brain waves and the entropy of heartrate during normal rest in all participants, whereas a significant correlation was observed during MBSR mindful breathing. Additionally, the most well-correlated brain regions were located in the central areas of the brain. This study provides a methodology for the establishment of evidence that mindfulness practice (i.e., mindful breathing) may increase the coordination between mind and heart activities.

This manuscript describes how to use the wavelet entropy index to analyze high-density electroencephalography (EEG) and electrocardiography (ECG) data. We show that the irregularity of cerebral and cardiac activities became more coordinated during mindfulness-based stress reduction practice.

In both the East and West, traditional teachings say that the mind and heart are somehow closely correlated, especially during spiritual practice. One ...

Calculating Heart Rate Variability from ECG Data from Youth with Cerebral Palsy During Active Video Game Sessions

The aim of this study was to generate a method for calculating heart rate variability (HRV) from electrocardiogram (ECG) waveforms. The waveforms were recorded by a HR monitor that participants (youth with cerebral palsy (CP)) wore during active video game (AVG) sessions. The AVG sessions were designed to promote physical activity and fitness (aerobic performance) in participants. The goal was to evaluate the feasibility of AVGs as a physical therapy (PT) intervention strategy. The maximum HR (mHR) was determined for each participant and the Target Heart Rate Zone (THRZ) was calculated for each of three exercise phases in the 20 min AVG session: (warm-up at 40-60% mHR, conditioning at 60-80% mHR, and cool down at 40-60% mHR). Each participant played three 20 min games during the AVG session. All games were played while sitting on a bench because many youth with CP cannot stand for extended periods of time. Each game condition differed with participants using hand icons only, hand and feet icons together or feet icons only to collect objects. The objective of the game (called KOLLECT) is to collect objects to gain points and avoid hazards to not lose points. Hazards were used in the warm-up and cool down phases only to promote slower, controlled movement to maintain HR in the target heart rate zone (THRZ). There were no hazards in the conditioning phase to promote higher levels and more intense physical activity. Analytic methods were used to generate HRV (selected time-domain and frequency-domain measures) from ECG data to examine aerobic workload. Recent applications of HRV indicate that short-term measurements (5 min bouts) are appropriate and that HRV biofeedback may help improve symptoms and the quality of life in a variety of health conditions. Although HR is a well-accepted clinical measure to examine aerobic performance and intensity in PT interventions, HRV may provide information of the autonomic system functions, recovery and adaptation during AVG sessions.

This protocol describes a method for calculating Heart Rate Variability (HRV) from electrocardiogram (ECG) waveforms. Waveforms from continuous heart rate (HR) recordings during active video game (AVG) sessions were used to measure the aerobic performance of youth with cerebral palsy (CP).

The aim of this study was to generate a method for calculating heart rate variability (HRV) from electrocardiogram (ECG) waveforms. The waveforms were ...

Real-Time Proxy-Control of Re-Parameterized Peripheral Signals using a Close-Loop Interface

The fields that develop methods for sensory substitution and sensory augmentation have aimed to control external goals using signals from the central nervous systems (CNS). Less frequent however, are protocols that update external signals self-generated by interactive bodies in motion. There is a paucity of methods that combine the body-heart-brain biorhythms of one moving agent to steer those of another moving agent during dyadic exchange. Part of the challenge to accomplish such a feat has been the complexity of the setup using multimodal bio-signals with different physical units, disparate time scales and variable sampling frequencies.
In recent years, the advent of wearable bio-sensors that can non-invasively harness multiple signals in tandem, has opened the possibility to re-parameterize and update the peripheral signals of interacting dyads, in addition to improving brain- and/or body-machine interfaces. Here we present a co-adaptive interface that updates efferent somatic-motor output (including kinematics and heart rate) using biosensors; parameterizes the stochastic bio-signals, sonifies this output, and feeds it back in re-parameterized form as visuo/audio-kinesthetic reafferent input. We illustrate the methods using two types of interactions, one involving two humans and another involving a human and its avatar interacting in near real time. We discuss the new methods in the context of possible new ways to measure the influences of external input on internal somatic-sensory-motor control.

We present protocols and methods of analyses to build co-adaptive interfaces that stream, parameterize, analyze, and modify human body and heart signals in close-loop. This setup interfaces signals derived from the peripheral and central nervous systems of the person with external sensory inputs to help track biophysical change.

The fields that develop methods for sensory substitution and sensory augmentation have aimed to control external goals using signals from the central ...

Group Synchronization During Collaborative Drawing Using Functional Near-Infrared Spectroscopy

Functional near-infrared spectroscopy (fNIRS) is a noninvasive method particularly suitable for measuring cerebral cortex activation in multiple subjects, which is relevant for studying group interpersonal interactions in ecological settings. Although many fNIRS systems technically offer the possibility to monitor more than two individuals simultaneously, establishing easy-to-implement setup procedures and reliable paradigms to track hemodynamic and behavioral responses in group interaction is still required. The present protocol combines fNIRS and video-based observation to measure interpersonal synchronization in quartets during a cooperative task.This protocol provides practical recommendations for data acquisition and paradigm design, as well as guiding principles for an illustrative data analysis example. The procedure is designed to assess differences in brain and behavior interpersonal responses between social and non-social conditions inspired by a well-known ice-breaker activity, the Collaborative Face Drawing Task. The described procedures can guide future studies to adapt group naturalistic social interaction activities to the fNIRS environment.

The present protocol combines functional near-infrared spectroscopy (fNIRS) and video-based observationto measure interpersonal synchronization in quartets during a collaborative drawing task.

Functional near-infrared spectroscopy (fNIRS) is a noninvasive method particularly suitable for measuring cerebral cortex activation in multiple subjects, ...

Unveiling Brain-Heart Interplay with EEG and Cardio Signals

BrainBeats as an Open-Source EEGLAB Plugin to Jointly Analyze EEG and Cardiovascular Signals

The interplay between the brain and the cardiovascular systems is garnering increased attention for its potential to advance our understanding of human physiology and improve health outcomes. However, the multimodal analysis of these signals is challenging due to the lack of guidelines, standardized signal processing and statistical tools, graphical user interfaces (GUIs), and automation for processing large datasets or increasing reproducibility. A further void exists in standardized EEG and heart-rate variability (HRV) feature extraction methods, undermining clinical diagnostics or the robustness of machine learning (ML) models. In response to these limitations, we introduce the BrainBeats toolbox. Implemented as an open-source EEGLAB plugin, BrainBeats integrates three main protocols: 1) Heartbeat-evoked potentials (HEP) and oscillations (HEO) for assessing time-locked brain-heart interplay at the millisecond accuracy; 2) EEG and HRV feature extraction for examining associations/differences between various brain and heart metrics or for building robust feature-based ML models; 3) Automated extraction of heart artifacts from EEG signals to remove any potential cardiovascular contamination while conducting EEG analysis. We provide a step-by-step tutorial for applying these three methods to an open-source dataset containing simultaneous 64-channel EEG, ECG, and PPG signals. Users can easily fine-tune parameters to tailor their unique research needs using the graphical user interface (GUI) or the command line. BrainBeats should make brain-heart interplay research more accessible and reproducible.

Author Spotlight: Advancing the Study of Brain-Heart Interplay with a Comprehensive EEGLAB Plugin for Multimodal Signal Analysis

The BrainBeats toolbox is an open-source EEGLAB plugin designed to jointly analyze EEG and cardiovascular (ECG/PPG) signals. It includes heartbeat-evoked potentials (HEP) assessment, feature-based analysis, and heart artifact extraction from EEG signals. The protocol will aid in studying brain-heart interplay through two lenses (HEP and features), enhancing reproducibility and accessibility.

The interplay between the brain and the cardiovascular systems is garnering increased attention for its potential to advance our understanding of human ...

Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging

Patients with obsessive-compulsive disorder (OCD) show heightened brain activity in limbic and orbitofrontal regions when confronted with negative emotions, which could be associated with impairments in emotion regulation skills. The ability to regulate emotions is a necessary coping mechanism when facing emotionally distressing situations, and deliberate emotion regulation strategies such as cognitive reappraisal have been extensively studied in the general population. Despite this, little is known about potential deliberate emotion regulation deficits in OCD patients and the associated neural correlates. Here, we describe a protocol to investigate the neural correlates of deliberate emotion regulation (cognitive reappraisal) using functional magnetic resonance imaging (fMRI) in OCD patients in comparison to a matched control sample. This protocol follows current gold standards for neuroimaging studies and includes both task activation and connectivity analysis (as well as behavioral data) to allow a more complete investigation. Therefore, we expect it will contribute to expanding the knowledge of the neural correlates of emotion (dys)regulation in OCD, and it could also be applied to explore emotion regulation deficits in other psychiatric disorders.

We introduce a protocol for exploring the neural correlates of a cognitive emotion regulation task, namely cognitive reappraisal, using functional magnetic resonance imaging. This protocol was used in patients with obsessive-compulsive disorder and healthy controls but can also be used in other clinical samples.