Abstract
Distress causes psychophysiological alterations that affect autonomic function. The current study explores psychophysiological modulation in diabetic distress in response to Surah Al-Rehman recitation. A single-group experimental study with before and after intervention assessments was conducted during April 2018 to February 2019 in which participants (n = 10) listened to Surah Al-Rehman recitation. Blood pressure, blood glucose, cortisol, ECG and EEG were recorded before and after recitation. Significant reduction in systolic blood pressure, increase in low frequency and absolute alpha power at Fp2 were observed. Heartbeat evoked potentials (HEP) were also significantly modulated at Fp1, Fp2 and F4. These findings suggest that Surah Al-Rehman modulated baroreflex activity thereby reducing sympathetic activity and improved heart brain coherence as reflected by HEP.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Al-Shargie, F., et al. (2016). Mental stress assessment using simultaneous measurement of EEG and fNIRS. Biomedical Optics Express, 7(10), 3882–3898. https://doi.org/10.1364/BOE.7.003882
Alcantara, J. M. A., et al. (2020). Impact of using different levels of threshold-based artefact correction on the quantification of heart rate variability in three independent human cohorts. Journal of Clinical Medicine. https://doi.org/10.3390/jcm9020325
Anderson, E. A., et al. (1991). Mental stress increases sympathetic nerve activity during sustained baroreceptor stimulation in humans. Hypertension, 17(4 Suppl), III43-49. https://doi.org/10.1161/01.hyp.17.4_suppl.iii43
Arnsten, A. F. (2009). Stress signalling pathways that impair prefrontal cortex structure and function. Nature Reviews: Neuroscience, 10(6), 410–422. https://doi.org/10.1038/nrn2648
Ayada, C., et al. (2015). The relationship of stress and blood pressure effectors. Hippokratia, 19(2), 99–108.
Azeemi, M., et al. (2020). Effectiveness of Maraqba in improving depression and reducing sympathetic tone in depressed females; A Quasi experimental study. Journal of Complementary Medicine Research. https://doi.org/10.5455/jcmr
Babamohamadi, H., et al. (2017). The effect of holy Qur’an recitation on depressive symptoms in hemodialysis patients: A randomized clinical trial. Journal of Religion and Health, 56(1), 345–354. https://doi.org/10.1007/s10943-016-0281-0
Bozovic, D., et al. (2013). Salivary cortisol levels as a biological marker of stress reaction. Medical Archives, 67(5), 374–377. https://doi.org/10.5455/medarh.2013.67.374-377
Braboszcz, C., et al. (2017). Increased gamma brainwave amplitude compared to control in three different meditation traditions. PLoS ONE, 12(1), e0170647. https://doi.org/10.1371/journal.pone.0170647
Chan, O., et al. (2003). Diabetes and the hypothalamo-pituitary-adrenal (HPA) axis. Minerva Endocrinologica, 28(2), 87–102.
de Looff, P. C., et al. (2018). Associations of sympathetic and parasympathetic activity in job stress and burnout: A systematic review. PLoS ONE, 13(10), e0205741. https://doi.org/10.1371/journal.pone.0205741
Dunbar, J. A., et al. (2008). Depression: An important comorbidity with metabolic syndrome in a general population. Diabetes Care, 31(12), 2368–2373. https://doi.org/10.2337/dc08-0175
Ferguson, J. M. (2001). SSRI antidepressant medications: Adverse effects and tolerability. Primary Care Companion to the Journal of Clinical Psychiatry, 3(1), 22–27. https://doi.org/10.4088/pcc.v03n0105
Fisher, J. P., et al. (2009). Central sympathetic overactivity: Maladies and mechanisms. Autonomic Neuroscience, 148(1–2), 5–15. https://doi.org/10.1016/j.autneu.2009.02.003
Frih, B., et al. (2017). Effects of listening to Holy Qur’an recitation and physical training on dialysis efficacy, functional capacity, and psychosocial outcomes in elderly patients undergoing haemodialysis. Libyan Journal of Medicine, 12(1), 1372032. https://doi.org/10.1080/19932820.2017.1372032
Gentsch, A., et al. (2019). Affective interoceptive inference: Evidence from heart-beat evoked brain potentials. Human Brain Mapping, 40(1), 20–33. https://doi.org/10.1002/hbm.24352
Ghiasi, A., & Keramat, A. (2018). The effect of listening to holy quran recitation on anxiety: A systematic review. Iranian Journal of Nursing and Midwifery Research, 23(6), 411–420. https://doi.org/10.4103/ijnmr.IJNMR_173_17
Goldstein, D. S., et al. (2011). Low-frequency power of heart rate variability is not a measure of cardiac sympathetic tone but may be a measure of modulation of cardiac autonomic outflows by baroreflexes. Experimental Physiology, 96(12), 1255–1261. https://doi.org/10.1113/expphysiol.2010.056259
Hartmann, R., et al. (2018). Heart rate variability as indicator of clinical state in depression. Frontiers in Psychiatry, 9, 735. https://doi.org/10.3389/fpsyt.2018.00735
Hata, M., et al. (2019). Short-term meditation modulates EEG activity in subjects with post-traumatic residual disabilities. Clinical Neurophysiology Practice, 4, 30–36. https://doi.org/10.1016/j.cnp.2019.01.003
Hussain, A., et al. (2018). Determinants of patients preferring complementary and alternative medicine attending public hospitals in Lahore, Pakistan. Journal of the Pakistan Medical Association, 68(6), 914–918.
Joseph, J. J., & Golden, S. H. (2017). Cortisol dysregulation: The bidirectional link between stress, depression, and type 2 diabetes mellitus. Annals of the New York Academy of Sciences, 1391(1), 20–34. https://doi.org/10.1111/nyas.13217
Kaur, C., & Singh, P. (2015). EEG derived neuronal dynamics during meditation: Progress and challenges. Advances in Preventive Medicine, 2015, 614723. https://doi.org/10.1155/2015/614723
Kern, M., et al. (2013). Heart cycle-related effects on event-related potentials, spectral power changes, and connectivity patterns in the human ECoG. NeuroImage, 81, 178–190. https://doi.org/10.1016/j.neuroimage.2013.05.042
Kreider, K. E. (2017). Diabetes distress or major depressive disorder? A practical approach to diagnosing and treating psychological comorbidities of diabetes. Diabetes Therapy, 8(1), 1–7. https://doi.org/10.1007/s13300-017-0231-1
Lin. T. A., & John, L. R. (2006). Quantifying mental relaxation with EEG for use in computer games. In Proceedings of the international conference on internet computing, Las Vegas, NV, USA
MacKinnon, S., et al. (2013). Utilizing heartbeat evoked potentials to identify cardiac regulation of vagal afferents during emotion and resonant breathing. Applied Psychophysiology and Biofeedback, 38(4), 241–255. https://doi.org/10.1007/s10484-013-9226-5
McCraty, R., et al. (2004). Electrophysiological evidence of intuition: Part 2. A system-wide process? Journal of Alternative and Complementary Medicine, 10(2), 325–336. https://doi.org/10.1089/107555304323062310
Moak, J. P., et al. (2007). Supine low-frequency power of heart rate variability reflects baroreflex function, not cardiac sympathetic innervation. Heart Rhythm, 4(12), 1523–1529. https://doi.org/10.1016/j.hrthm.2007.07.019
Montoya, P., et al. (1993). Heartbeat evoked potentials (HEP): Topography and influence of cardiac awareness and focus of attention. Electroencephalography and Clinical Neurophysiology, 88(3), 163–172. https://doi.org/10.1016/0168-5597(93)90001-6
Newson, J. J., & Thiagarajan, T. C. (2018). EEG frequency bands in psychiatric disorders: A review of resting state studies. Frontiers in Human Neuroscience, 12, 521. https://doi.org/10.3389/fnhum.2018.00521
Pansuria, M., et al. (2012). Insulin resistance, metabolic stress, and atherosclerosis. Frontiers in Bioscience (scholar Edition), 4, 916–931. https://doi.org/10.2741/s308
Park, H., et al. (2018). Heart rate variability as a marker of distress and recovery: The effect of brief supportive expressive group therapy with mindfulness in cancer patients. Integrative Cancer Therapies, 17(3), 825–831. https://doi.org/10.1177/1534735418756192
Perakakis, P. (2019). HEPLAB: A Matlab graphical interface for the preprocessing of the heartbeat-evoked potential (Version v1.0.0). In Zenodo. https://doi.org/10.5281/zenodo.2649943
Perez, J. J., et al. (2005). Suppression of the cardiac electric field artifact from the heart action evoked potential. Medical & Biological Engineering and Computing, 43(5), 572–581. https://doi.org/10.1007/BF02351030
Petzschner, F. H., et al. (2019). Focus of attention modulates the heartbeat evoked potential. NeuroImage, 186, 595–606. https://doi.org/10.1016/j.neuroimage.2018.11.037
Polonsky, W. H., & Henry, R. R. (2016). Poor medication adherence in type 2 diabetes: Recognizing the scope of the problem and its key contributors. Patient Preference and Adherence, 10, 1299–1307. https://doi.org/10.2147/PPA.S106821
Rafique, R., et al. (2019). Efficacy of Surah Al-Rehman in managing depression in Muslim Women. Journal of Religion and Health., 58(2), 516–526. https://doi.org/10.1007/s10943-017-0492-z
Roohafza, H., et al. (2014). Relationship between metabolic syndrome and its components with psychological distress. International Journal of Endocrinology, 2014, 203463. https://doi.org/10.1155/2014/203463
Saquib, N., et al. (2017). Health benefits of Quran memorization for older men. SAGE Open Medicine, 5, 2050312117740990. https://doi.org/10.1177/2050312117740990
Schandry, R., et al. (1986). From the heart to the brain: A study of heartbeat contingent scalp potentials. International Journal of Neuroscience, 30(4), 261–275. https://doi.org/10.3109/00207458608985677
Schandry, R., & Weitkunat, R. (1990). Enhancement of heartbeat-related brain potentials through cardiac awareness training. International Journal of Neuroscience, 53(2–4), 243–253. https://doi.org/10.3109/00207459008986611
Shaffer, F., & Ginsberg, J. P. (2017). An overview of heart rate variability metrics and norms. Frontiers in Public Health, 5, 258. https://doi.org/10.3389/fpubh.2017.00258
Shaikh, B. T., & Hatcher, J. (2005). Complementary and alternative medicine in pakistan: prospects and limitations. Evidence-Based Complementary and Alternative Medicine, 2(2), 139–142. https://doi.org/10.1093/ecam/neh088
Shams, N., et al. (2016). Drug non-adherence in type 2 diabetes mellitus; Predictors and associations. Journal of Ayub Medical College, Abbottabad, 28(2), 302–307.
Srivastava, K., et al. (2010). Neuropsychophysiological correlates of depression. Industrial Psychiatry Journal, 19(2), 82–89. https://doi.org/10.4103/0972-6748.90336
Tarvainen, M. P., et al. (2014). Kubios HRV–heart rate variability analysis software. Computer Methods and Programs in Biomedicine, 113(1), 210–220. https://doi.org/10.1016/j.cmpb.2013.07.024
Terhaar, J., et al. (2012). Heartbeat evoked potentials mirror altered body perception in depressed patients. Clinical Neurophysiology, 123(10), 1950–1957. https://doi.org/10.1016/j.clinph.2012.02.086
Vaccarino, V., et al. (2008). Depressive symptoms and heart rate variability: Evidence for a shared genetic substrate in a study of twins. Psychosomatic Medicine, 70(6), 628–636. https://doi.org/10.1097/PSY.0b013e31817bcc9e
Vogel, R. A. (2006). Diabetes and metabolic syndrome. Texas Heart Institute Journal, 33(2), 184–186.
Won, E., & Kim, Y. K. (2016). Stress, the autonomic nervous system, and the immune-kynurenine pathway in the etiology of depression. Current Neuropharmacology, 14(7), 665–673. https://doi.org/10.2174/1570159x14666151208113006
Yokoyama, K., et al. (2015). Relationship between hypothalamic-pituitary-adrenal axis dysregulation and insulin resistance in elderly patients with depression. Psychiatry Research, 226(2–3), 494–498. https://doi.org/10.1016/j.psychres.2015.01.026
Yuan, H., et al. (2007). Effect of heartbeat perception on heartbeat evoked potential waves. Neuroscience Bulletin, 23(6), 357–362. https://doi.org/10.1007/s12264-007-0053-7
Acknowledgements
We would like to thank Ms. Angelique de Graff and Dr. Shah Kamal Hashmi for critically reviewing this paper for English corrections.
Funding
This work was supported by JSMU Research Fund (Grant No. URFC-10) and Transformation International Society.
Author information
Authors and Affiliations
Contributions
MFA conceived the idea of this work. SA, UM and DM Baloch contributed to participant recruitment and data collection. AH and MFA performed data analysis. IMY arranged the funding for this work. MFA formulated the basic structure of this article which was critically reviewed by AH, IMY and SQ and added the intellectual content to this article.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Human and Animal Rights
Jinnah Sind Medical University, Institutional Review Board reviewed and approved the study (Approval No. JSMU/IRB/2017/-90).
Informed Consent
Written and informed consent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Majeed, U., Aftab, M.F., Baloch, D.M. et al. Modulation of Heart and Brain Function by Surah Al-Rehman Recitation Among Distressed Diabetic Patients in Pakistan. J Relig Health 61, 3852–3865 (2022). https://doi.org/10.1007/s10943-021-01431-2
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10943-021-01431-2