Humans have developed mechanisms of emotion regulation for adaptation for social environments. Here, based on conceptualization by Spinoza, William James, and Antonio Damasio, we recognize emotions as bodily responses to external and internal stimuli and representation of the responses in the brain. Using simultaneous recording technique of neuroimaging and physiological responses, we examined functional association of brain and body accompanying emotion regulation. As results, it was revealed that the lateral and medial parts of prefrontal cortex and the orbitofrontal cortex play important roles for inhibitory control over limbic structures including the amygdala. Furthermore, peripheral physiological responses are projected to the brain, especially in the anterior insula as "somatic marker", and influence subjective experiences of emotions. We propose that biofeedback can provide a unique experimental framework to examine such brain and body interaction accompanying emotional phenomena.

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The control of tremors is needed to improve a daily life of a patient with Parkinson's disease (PD) or Essential tremor disease. For the treatment of PD tremors, L-DOPA as a precursor of dopamine is used. However it has serious side effects such as the ON-OFF phenomena and delusions. I aimed to regulate the tremor amplitude of the patients by using biofeedback (BF). My investigation has covered the following points : 1. Research of the objective tremor evaluation index 2. Construction of a tremor disease diagnosis system 3. Construction of BF training system for controlling of the tremor amplitude In this paper, I have described the studies and have discussed a possible way of BF training for controlling the tremor amplitude. In addition, as an engineer, I will describe how the advance of this biofeedback research will contribute to society in the future.

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In recent years, medical and other healthcare professionals have increasingly focused on mind-body interaction, to gain understanding of mechanisms underlying physiological symptoms and illnesses. Availability of ambulatory biofeedback equipment in conventional practice, along with growing evidence to support the efficacy of the "heart-rate variability biofeedback (HRV-BF)" technique, has led to an increased interest in collaborative research projects. Researchers, previously unfamiliar with biofeedback techniques, are forming alliances to treat and control various physical symptoms with psycho-physiological methods. At the University of Medicine and Dentistry of New Jersey, our team, in collaboration with other departments and universities, has investigated HRV-BF in treatment of asthma, major depression, fibromyalgia and inflammation. In the course of a decade, our studies have consistently produced positive findings, with promising effects on symptoms and illnesses that lack adequate medical treatments. A high number of near-fatal traffic accidents in the State of New Jersey results in spinal cord injury (SCI). In many SCI cases above Th4-5, the trauma is associated with Autonomic Dysreflexia (AD), a syndrome characterized by a sudden surge of sympathetic activity and an abrupt onset of high blood pressure (200/100mmHg or greater). If not treated promptly and effectively, it may lead to seizures, stroke, heart attacks and even death. The effectiveness of anti-hypertensive medications commonly used to control symptoms of AD is limited. In our most recent project, we used HRV-BF to treat AD in patients with SCI. HRV-BF may be an affordable, safe, and effective way to manage AD symptoms. Our preliminary findings provide support for the safe use of HRV-BF in AD.

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It is possible that a combination of biofeedback (BF) and psychotherapy is effective in the treatment of muscle tension. Several studies have reported that EMG-BF combined with Autogenic training (AT) was effective for spasmodic torticollis. AT is a method of concentrating on proprioception through self-hypnotic suggestion (formula). Ishida et al. (2000) explored the effect of EMG-BF while concentrating on trapezius muscle relaxation. In this study, participants were randomly assigned to EMG-BF, concentration, and EMG-BF combined with concentration conditions. Results indicated that there was a significant decrease in muscle tension as indicated by the EMG in the EMG-BF with concentration condition, compared with the other two conditions. Although combining EMG-BF and AT might be useful for muscle relaxation, other relaxation techniques must be combined with EMG-BF for patients who are unable to learn AT. Sakakibara et al. (1993) in a study of two patients with spasmodic torticollis has reported that breathing exercises with prolonged respiratory exhalation was useful as a strategy for muscle relaxation. In this study, the treatment to reduce the tension of sternocleidomastoid muscle consisted of (1) an EMG-BF session (2) an EMG-BF with breathing exercise session, and (3) a breathing exercise session, in this order. Results indicated that the average tension of the sternocleidomastoid muscles was reduced during each session as indicated by the EMG. After the first and second session, however, the patients could suppress muscle tension using only the breathing exercise, and moreover, their complaints improved following treatment. Sakakibara et al. (2002) has reported that although muscle tension was reduced through relaxation training (EMG-BF and AT) everyday symptoms remained unchanged in patients with spasmodic torticollis. Thus, Solution-focused therapy (SFT) was used for muscle control in daily life. During the SFT sessions, the therapist focused on the patient's solution image, and the patient not only described his future goals, but also performed muscle control during various daily life activities. After four sessions of SFT, the symptoms improved. It is concluded (1) that combining BF and psychotherapy may be a helpful relaxation technique to reduce muscle tension in patients with spasmodic torticollis, and (2) SFT may contribute to the spontaneous behavior of patients and to the control of symptoms in daily life. Psychotherapeutic approaches to BF might also enhance motivation.

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In our previous study, we performed biofeedback (BF) therapy (direct method) and electroencephalogram (EEG)-BF therapy (indirect method) by using a monitoring system (harmonized alert sensing technology ; HASTE) that is used in hospital wards and other treatment centers for treating hypertension/white-coat hypertension, and we clarified the effectiveness of these therapy systems. In this study, we compare the effects of both the direct and indirect BF therapy methods combined with relaxation therapy. The results for both the study groups revealed significant reductions in blood pressure during the shrinkage period, in general blood pressure, and in the plasma levels of adrenaline and significant improvements in anxiety and depression. As compared to the results obtained for these 2 groups, we observed more significant blood pressure reductions among patients who visited the outpatient clinic (for the shrinkage period : 1〜4 times, a diastole : 1〜7 times) by using the direct method (combined with relaxation) than by using the indirect method (combined with relaxation) In summary, the direct method (combined with relaxation) influences blood pressure at an earlier stage than the indirect method (combined with relaxation) does, and the former is effective even after 6 months.

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