Heart rate variability as a marker of stress and health - measurements with the 'magic ring'

This post is a follow-up to the previous post on brain-heart interplay in emotional arousal, and points to Thayer et al.'s meta-analysis of heart rate variability (HRV) and neuroimaging studies to evaluate HRV as a marker of stress and health. I'm curious about the practical usefulness of the heart rate (HR) and heart rate variability (HRV) measurements that have been reported by the Oura Ring bio-monitor I purchased over six months ago, and has been measuring my sleep, heart rate, activity, and body temperature (I call it the 'magic ring'). I'm finding an allmost complete correlation between the ring's HRV overnight measurements and my subjective sense of robustness and health on waking in the mornings. HRV is lower after a previous day of physical, social, (or gastronomic!) stress, and higher after a day of rest and relaxation. Here I pass on just one clip from the text:

Resting HRV, in our view, is a marker for flexible dynamic regulation of autonomic activity; thus, higher HRV signals the availability of context- and goal-based control of emotions. We have investigated the role of HRV in emotional regulation at two different levels of analysis. One level is at the trait or tonic level where individual differences in resting HRV have been associated with differences in emotional regulation. We have shown that individuals with higher levels of resting HRV, compared to those with lower resting levels, produce context appropriate emotional responses as indexed by emotion-modulated startle responses, fear-potentiated startle responses, and phasic heart rate responses in addition to behav- ioral and self-reported emotional responses (Melzig et al., 2009; Ruiz-Padial et al., 2003; Thayer and Brosschot, 2005). In addition, we have recently shown that individuals with low resting HRV show delayed recovery from psychological stressors of cardiovascular, endocrine, and immune responses compared to those with higher levels of resting HRV (Weber et al., 2010). Thus, individuals with higher resting levels of HRV appear more able to produce context appropriate responses including appropriate recovery after the stressor has ended.

And here is the article's abstract:

The intimate connection between the brain and the heart was enunciated by Claude Bernard over 150 years ago. In our neurovisceral integration model we have tried to build on this pioneering work. In the present paper we further elaborate our model and update it with recent results. Specifically, we per- formed a meta-analysis of recent neuroimaging studies on the relationship between heart rate variability and regional cerebral blood flow. We identified a number of regions, including the amygdala and ventro- medial prefrontal cortex, in which significant associations across studies were found. We further propose that the default response to uncertainty is the threat response and may be related to the well known neg- ativity bias. Heart rate variability may provide an index of how strongly ‘top–down’ appraisals, mediated by cortical-subcortical pathways, shape brainstem activity and autonomic responses in the body. If the default response to uncertainty is the threat response, as we propose here, contextual information repre- sented in ‘appraisal’ systems may be necessary to overcome this bias during daily life. Thus, HRV may serve as a proxy for ‘vertical integration’ of the brain mechanisms that guide flexible control over behavior with peripheral physiology, and as such provides an important window into understanding stress and health.

Brain-Heart interplay in emotional arousal - resolving a hundred year old debate

Candia-Rivera et al. do a fascinating piece of work that answers some long-standing issues in the century old debate on the role of the autonomic nervous system in feelings. I will be slowly re-reading this paper a number of times. The introduction provides an excellent review of contrasting theories of what emotions are.

...The debate about the role of the ANS in emotions can be condensed into two views: specificity or causation. The specificity view is related to the James–Lange theory, which states that bodily responses precede emotions’ central processing, meaning that bodily states would be a response to the environment, followed by an interpretation carried out by the CNS that would result in the feeling felt. However, causation theories represent an updated view of the James–Lange theory, suggesting that peripheral changes influence the conscious emotional experience....While more “classical” theories point to emotions as “the functional states of the brain that provide causal explanations of certain complex behaviors—like evading a predator or attacking prey”, other theories suggest how they are constructions of the world, not reactions to it (see MindBlog posts on Lisa Feldman Barretts work). Namely, emotions are internal states constructed on the basis of previous experiences as predictive schemes to react to external stimuli.

Here is a clip from the discussion of their open source paper, followed by the significance and abstract sections at the begninning of the article:

....To the best of our knowledge, major novelties of the current study with respect to prior state of the art are related to 1) the uncovering of the directed functional interplay between central and peripheral neural dynamics during an emotional elicitation, using ad-hoc mathematical models for synchronized EEG and ECG time series; 2) the uncovering of temporal dynamics of cortical and cardiovascular neural control during emotional processing in both ascending, from the heart to the brain, and descending, from the brain to the heart, functional directions; and 3) the experimental support for causation theories of physiological feelings.

In the frame of investigating the visceral origin of emotions, main findings of this study suggest that ascending BHI (brain-heart interplay) coupling initiates emotional processing and is mainly modulated by the subjective experience of emotional arousal. Such a relationship between arousal and ascending BHI may not be related to the attention levels, as controlled with two different neural correlates of attention. The main interactions begin through afferent vagal pathways (HF power) sustaining EEG oscillations, in which the theta band was repeatedly found related to major vagal modulations. In turn, with a later onset, this ascending modulation actually triggers a cascade of cortical neural activations that, in turn, modulate directed neural control onto the heart, namely from-brain-to-heart interplay. Concurrent bidirectional communication between the brain and body occurs throughout the emotional processing at specific timings, reaching a maximum coupling around 15 to 20 s from the elicitation onset, involving both cardiac sympathetic and vagal activity.

From the beginning of the article;  

Significance

We investigate the temporal dynamics of brain and cardiac activities in healthy subjects who underwent an emotional elicitation through videos. We demonstrate that, within the first few seconds, emotional stimuli modulate heartbeat activity, which in turn stimulates an emotion intensity (arousal)–specific cortical response. The emotional processing is then sustained by a bidirectional brain–heart interplay, where the perceived arousal level modulates the amplitude of ascending heart-to-brain neural information flow. These findings may constitute fundamental knowledge linking neurophysiology and psychiatric disorders, including the link between depressive symptoms and cardiovascular disorders.

Abstract

A century-long debate on bodily states and emotions persists. While the involvement of bodily activity in emotion physiology is widely recognized, the specificity and causal role of such activity related to brain dynamics has not yet been demonstrated. We hypothesize that the peripheral neural control on cardiovascular activity prompts and sustains brain dynamics during an emotional experience, so these afferent inputs are processed by the brain by triggering a concurrent efferent information transfer to the body. To this end, we investigated the functional brain–heart interplay under emotion elicitation in publicly available data from 62 healthy subjects using a computational model based on synthetic data generation of electroencephalography and electrocardiography signals. Our findings show that sympathovagal activity plays a leading and causal role in initiating the emotional response, in which ascending modulations from vagal activity precede neural dynamics and correlate to the reported level of arousal. The subsequent dynamic interplay observed between the central and autonomic nervous systems sustains the processing of emotional arousal. These findings should be particularly revealing for the psychophysiology and neuroscience of emotions.

How stress might help reduce dementia and alzheimer’s.

The post today (my 80th birthday) points to experimental results relevant to my interest in not losing my marbles anytime soon. Fauzia points to work by Avezov and collaborators (open source) showing that the accumulation of aggregates of misfolded proteins in the endoplasmic reticulum of brain cells that is associated with dementia and Alzheimer's can be reversed by stressing cells with chemicals or heat, activating molecular chaperones that in turn untangle or remove protein aggregates. How much stress is just enough, but not to much, isn't clear. The abstract of the work:

Protein synthesis is supported by cellular machineries that ensure polypeptides fold to their native conformation, whilst eliminating misfolded, aggregation prone species. Protein aggregation underlies pathologies including neurodegeneration. Aggregates’ formation is antagonised by molecular chaperones, with cytoplasmic machinery resolving insoluble protein aggregates. However, it is unknown whether an analogous disaggregation system exists in the Endoplasmic Reticulum (ER) where ~30% of the proteome is synthesised. Here we show that the ER of a variety of mammalian cell types, including neurons, is endowed with the capability to resolve protein aggregates under stress. Utilising a purpose-developed protein aggregation probing system with a sub-organellar resolution, we observe steady-state aggregate accumulation in the ER. Pharmacological induction of ER stress does not augment aggregates, but rather stimulate their clearance within hours. We show that this dissagregation activity is catalysed by the stress-responsive ER molecular chaperone – BiP. This work reveals a hitherto unknow, non-redundant strand of the proteostasis-restorative ER stress response.

The human fear paradox: Affective origins of cooperative care

On the same morning last week that I read a NYTimes essay by Thomas Edsall "The Politics of Fear Show No Sign of Abating" I received an email from the journal Behavioral and Brain Science soliciting reviews on an upcoming article by Tobias Grossmann with an interesting hypothesis on why we humans are so fearful: "The human fear paradox: Affective origins of cooperative care." His 'fearful ape hypothesis' proposes that, in the context of the strong interdependence reflected in cooperative caregiving and provisioning unique to human great ape group life, heightened fearfulness was adaptive. Here I pass on the abstract of Grossmann's piece, and motivated readers can obtain the whole text from me.

Already as infants humans are more fearful than our closest living primate relatives, the chimpanzees. Yet heightened fearfulness is mostly considered maladaptive, as it is thought to increase the risk of developing anxiety and depression. How can this human fear paradox be explained? The fearful ape hypothesis presented herein stipulates that, in the context of cooperative caregiving and provisioning unique to human great ape group life, heightened fearfulness was adaptive. This is because from early in ontogeny fearfulness expressed and perceived enhanced care-based responding and provisioning from, while concurrently increasing cooperation with, mothers and others. This explanation is based on a synthesis of existing research with human infants and children, demonstrating a link between fearfulness, greater sensitivity to and accuracy in detecting fear in others, and enhanced levels of cooperative behaviors. These insights critically advance current evolutionary theories of human cooperation by adding an early-developing affective component to the human cooperative makeup. Moreover, the current proposal has important cultural, societal and health implications, as it challenges the predominant view in WEIRD societies that commonly construe fearfulness as a maladaptive trait, potentially ignoring its evolutionary adaptive functions.

Magic mind therapy….. Moving your body.

Gretchen Reynolds interviews Jennifer Heisz about the contents of her new book "Move the Body, Heal the Mind," which details the latest science about exercise and mental health, especially its potential to reduce anxiety and stress. The brief reprieve from anxiety than can sometimes be experienced after a workout is due to the release of neuropeptide Y, known to dampen hyperactivity of the anxious amygdala. Exercise also can reduce stress-induced body inflammation that damages cells and affects mood. These effects require only about a quarter of the normally recommended 150 minutes of moderate to vigorous exercise a week, so the exercise prescription for mental health seems to be less than that for physical health.

Mellow Mice - Why deep breathing can keep us calm

How we are breathing is usally a good indicator of whether we are calm or aroused. When we become anxious or aroused, usually the best thing we can do is stop and take a deep breath. Gretchen Reynolds points to interesting work in mice that suggests that taking deep breaths is calming because it does not activate neurons in the brain's breathing center that communicate with the brain's arousal center (breathing pacemakers in humans closely resemble those in mice). Here is the abstract from Yackle et al.:

Slow, controlled breathing has been used for centuries to promote mental calming, and it is used clinically to suppress excessive arousal such as panic attacks. However, the physiological and neural basis of the relationship between breathing and higher-order brain activity is unknown. We found a neuronal subpopulation of about 350 neurons in the mouse preBötzinger complex (preBötC), the primary breathing rhythm generator, which regulates the balance between calm and arousal behaviors. Conditional, bilateral genetic ablation of the ~175 Cdh9/Dbx1 double-positive preBötC neurons in adult mice left breathing intact but increased calm behaviors and decreased time in aroused states. These neurons project to, synapse on, and positively regulate noradrenergic neurons in the locus coeruleus, a brain center implicated in attention, arousal, and panic that projects throughout the brain.

Listening to our bodies can make us more resilient to stress

Jane Brody points to work from Haas et al. suggesting that resilience is more about body awareness than rational thinking. In their experiments subjects who had more subjective awareness of their internal feelings were less emotionally reactive to stress (showing less heart rate increase, shallow breathing, blood adrenaline increase), and recovered more quickly from it. Increased awareness of interoceptive stress signals from the body appears to enable stronger top-down suppression of the stress response. Here is the abstract from the Haas et al. article:

This study examined neural processes of resilience during aversive interoceptive processing. Forty-six individuals were divided into three groups of resilience Low (LowRes), high (HighRes), and normal (NormRes), based on the Connor-Davidson Resilience Scale (2003). Participants then completed a task involving anticipation and experience of loaded breathing during functional magnetic resonance imaging (fMRI) recording. Compared to HighRes and NormRes groups, LowRes self-reported lower levels of interoceptive awareness and demonstrated higher insular and thalamic activation across anticipation and breathing load conditions. Thus, individuals with lower resilience show reduced attention to bodily signals but greater neural processing to aversive bodily perturbations. In low resilient individuals, this mismatch between attention to and processing of interoceptive afferents may result in poor adaptation in stressful situations.

Threatening language is contagious - Tracking America’s collective response to threats with a linguistic tool

From Choi et al.:  

Significance

People are constantly exposed to threatening language in mass communication channels, yet we lack tools to identify language about threats and track its impact on human groups. We developed a threat dictionary, a computationally derived linguistic tool that indexes threat levels from texts with high temporal resolution, across media platforms, and for different levels of analysis. The dictionary shows convergent validity with objective threats in American history, including violent conflicts, natural disasters, and pathogen outbreaks. Moreover, fluctuations in threat levels from the past 100 years coincide with America’s shifting cultural norms, political attitudes, and macroeconomic activity, demonstrating how this linguistic tool can be applied to understand the collective shifts associated with mass communicated threats.

Abstract

In today’s vast digital landscape, people are constantly exposed to threatening language, which attracts attention and activates the human brain’s fear circuitry. However, to date, we have lacked the tools needed to identify threatening language and track its impact on human groups. To fill this gap, we developed a threat dictionary, a computationally derived linguistic tool that indexes threat levels from mass communication channels. We demonstrate this measure’s convergent validity with objective threats in American history, including violent conflicts, natural disasters, and pathogen outbreaks such as the COVID-19 pandemic. Moreover, the dictionary offers predictive insights on US society’s shifting cultural norms, political attitudes, and macroeconomic activities. Using data from newspapers that span over 100 years, we found change in threats to be associated with tighter social norms and collectivistic values, stronger approval of sitting US presidents, greater ethnocentrism and conservatism, lower stock prices, and less innovation. The data also showed that threatening language is contagious. In all, the language of threats is a powerful tool that can inform researchers and policy makers on the public’s daily exposure to threatening language and make visible interesting societal patterns across American history.

Severity and clinical course of depression correlates with altered connectivity in sensorimotor cortices.

Interesting work from Ray et al.,  

Significance

Research into neurobiology of depression primarily focuses on its complex psychological aspects. Here we propose an alternative approach and target sensorimotor alterations—a prominent but often neglected feature of depression. We demonstrated using resting-state functional MRI data and computational modeling that top-down and bottom-up information flow in sensory and motor cortices is altered with increasing depression severity in a way that is consistent with depression symptoms. Depression-associated changes were found to be consistent across sessions, amenable to treatment and of effect size sufficiently large to predict whether somebody has mild or severe depression. These results pave the way for an avenue of research into the neural underpinnings of mental health conditions.

Abstract

Functional neuroimaging research on depression has traditionally targeted neural networks associated with the psychological aspects of depression. In this study, instead, we focus on alterations of sensorimotor function in depression. We used resting-state functional MRI data and dynamic causal modeling (DCM) to assess the hypothesis that depression is associated with aberrant effective connectivity within and between key regions in the sensorimotor hierarchy. Using hierarchical modeling of between-subject effects in DCM with parametric empirical Bayes we first established the architecture of effective connectivity in sensorimotor cortices. We found that in (interoceptive and exteroceptive) sensory cortices across participants, the backward connections are predominantly inhibitory, whereas the forward connections are mainly excitatory in nature. In motor cortices these parities were reversed. With increasing depression severity, these patterns are depreciated in exteroceptive and motor cortices and augmented in the interoceptive cortex, an observation that speaks to depressive symptomatology. We established the robustness of these results in a leave-one-out cross-validation analysis and by reproducing the main results in a follow-up dataset. Interestingly, with (nonpharmacological) treatment, depression-associated changes in backward and forward effective connectivity partially reverted to group mean levels. Overall, altered effective connectivity in sensorimotor cortices emerges as a promising and quantifiable candidate marker of depression severity and treatment response.

Cannabis use during pregnancy correlates with cortisol, anxiety, aggression, and hyperactivity in young children.

Sobering results from Rompala et al.: 

Significance

Cannabis use is becoming more prevalent, including during developmentally sensitive periods such as pregnancy. Here we find that maternal cannabis use is associated with increased cortisol, anxiety, aggression, and hyperactivity in young children. This corresponded with widespread reductions in immune-related gene expression in the placenta which correlated with anxiety and hyperactivity. Future studies are needed to examine the effects of cannabis on immune function during pregnancy as a potential regulatory mechanism shaping neurobehavioral development.

Abstract

While cannabis is among the most used recreational drugs during pregnancy, the impact of maternal cannabis use (mCB) on fetal and child development remains unclear. Here, we assessed the effects of mCB on psychosocial and physiological measures in young children along with the potential relevance of the in utero environment reflected in the placental transcriptome. Children (∼3 to 6 y) were assessed for hair hormone levels, neurobehavioral traits on the Behavioral Assessment System for Children (BASC-2) survey, and heart rate variability (HRV) at rest and during auditory startle. For a subset of children with behavioral assessments, placental specimens collected at birth were processed for RNA sequencing. Hair hormone analysis revealed increased cortisol levels in mCB children. In addition, mCB was associated with greater anxiety, aggression, and hyperactivity. Children with mCB also showed a reduction in the high-frequency component of HRV at baseline, reflecting reduced vagal tone. In the placenta, there was reduced expression of many genes involved in immune system function including type I interferon, neutrophil, and cytokine-signaling pathways. Finally, several of these mCB-linked immune genes organized into coexpression networks that correlated with child anxiety and hyperactivity. Overall, our findings reveal a relationship between mCB and immune response gene networks in the placenta as a potential mediator of risk for anxiety-related problems in early childhood.

Our brainstems respond to fake therapies and fake side effects.

Here is the abstract from a Journal of Neuroscience paper by Crawford et al. titled "Brainstem mechanisms of pain modulation: a within-subjects 7T fMRI study of Placebo Analgesic and Nocebo Hyperalgesic Responses":

Pain perception can be powerfully influenced by an individual’s expectations and beliefs. Whilst the cortical circuitry responsible for pain modulation has been thoroughly investigated, the brainstem pathways involved in the modulatory phenomena of placebo analgesia and nocebo hyperalgesia remain to be directly addressed. This study employed ultra-high field 7 Tesla functional MRI (fMRI) to accurately resolve differences in brainstem circuitry present during the generation of placebo analgesia and nocebo hyperalgesia in healthy human participants (N = 25; 12 Male). Over two successive days, through blinded application of altered thermal stimuli, participants were deceptively conditioned to believe that two inert creams labelled ‘lidocaine’ (placebo) and ‘capsaicin’ (nocebo) were acting to modulate their pain relative to a third ‘Vaseline’ (control) cream. In a subsequent test phase, fMRI image sets were collected whilst participants were given identical noxious stimuli to all three cream sites. Pain intensity ratings were collected and placebo and nocebo responses determined. Brainstem-specific fMRI analysis revealed altered activity in key pain-modulatory nuclei, including a disparate recruitment of the periaqueductal gray (PAG) – rostral ventromedial medulla (RVM) pathway when both greater placebo and nocebo effects were observed. Additionally, we found that placebo and nocebo responses differentially activated the parabrachial nucleus but overlapped in their engagement of the substantia nigra and locus coeruleus. These data reveal that placebo and nocebo effects are generated through differential engagement of the PAG-RVM pathway, which in concert with other brainstem sites likely influence the experience of pain by modulating activity at the level of the dorsal horn.

National religiosity eases the psychological burden of poverty

From Berkessel et al.:  

Significance

According to a fundamental assumption in the social sciences, the burden of lower socioeconomic status (SES) is more severe in developing nations. In contrast to this assumption, recent research has shown that the burden of lower SES is less—not more—severe in developing nations. In three large-scale global data sets, we show that national religiosity can explain this puzzling finding. Developing nations are more religious, and most world religions uphold norms that, in part, function to ease the burden of lower SES and to cast a bad light on higher SES. In times of declining religiosity, this finding is a call to scientists and policymakers to monitor the increasingly harmful effects of lower SES and its far-reaching social consequences.

Abstract

Lower socioeconomic status (SES) harms psychological well-being, an effect responsible for widespread human suffering. This effect has long been assumed to weaken as nations develop economically. Recent evidence, however, has contradicted this fundamental assumption, finding instead that the psychological burden of lower SES is even greater in developed nations than in developing ones. That evidence has elicited consternation because it suggests that economic development is no cure for the psychological burden of lower SES. So, why is that burden greatest in developed nations? Here, we test whether national religiosity can explain this puzzle. National religiosity is particularly low in developed nations. Consequently, developed nations lack religious norms that may ease the burden of lower SES. Drawing on three different data sets of 1,567,204, 1,493,207, and 274,393 people across 156, 85, and 92 nations, we show that low levels of national religiosity can account for the greater burden of lower SES in developed nations. This finding suggests that, as national religiosity continues to decline, lower SES will become increasingly harmful for well-being—a societal change that is socially consequential and demands political attention.

Seeing others react to threats triggers our own internal threat responses.

From Haaker et al. (open source): 

Significance

Social transmission of threat information by observation is effective in humans and other animals. However, it is unknown if such observation of others’ reacting to threats can retrieve memories that have been previously learned through direct, firsthand aversive experiences. Here, we show concordantly in humans and rats that observing a conspecific’s reactions to a threat is sufficient to recover associative memories of direct, firsthand aversive experiences, measured as conditioned threat responses (physiological responses and defensive behavior) in the observer. The reinstatement of threat responses by observation of others is specific to the context that is observed as being dangerous. Our findings provide cross-species evidence that observation of others’ threat reactions can recover associative memories of direct, firsthand aversive experiences.

Abstract

Information about dangers can spread effectively by observation of others’ threat responses. Yet, it is unclear if such observational threat information interacts with associative memories that are shaped by the individual’s direct, firsthand experiences. Here, we show in humans and rats that the mere observation of a conspecific’s threat reactions reinstates previously learned and extinguished threat responses in the observer. In two experiments, human participants displayed elevated physiological responses to threat-conditioned cues after observational reinstatement in a context-specific manner. The elevation of physiological responses (arousal) was further specific to the context that was observed as dangerous. An analogous experiment in rats provided converging results by demonstrating reinstatement of defensive behavior after observing another rat’s threat reactions. Taken together, our findings provide cross-species evidence that observation of others’ threat reactions can recover associations previously shaped by direct, firsthand aversive experiences. Our study offers a perspective on how retrieval of threat memories draws from associative mechanisms that might underlie both observations of others’ and firsthand experiences.

Historical language records reveal societal depression and anxiety in past two decades higher than during 20th century.

Fascinating work from Bollen et al. (open source):  

Significance

Can entire societies become more or less depressed over time? Here, we look for the historical traces of cognitive distortions, thinking patterns that are strongly associated with internalizing disorders such as depression and anxiety, in millions of books published over the course of the last two centuries in English, Spanish, and German. We find a pronounced “hockey stick” pattern: Over the past two decades the textual analogs of cognitive distortions surged well above historical levels, including those of World War I and II, after declining or stabilizing for most of the 20th century. Our results point to the possibility that recent socioeconomic changes, new technology, and social media are associated with a surge of cognitive distortions.

Abstract

Individuals with depression are prone to maladaptive patterns of thinking, known as cognitive distortions, whereby they think about themselves, the world, and the future in overly negative and inaccurate ways. These distortions are associated with marked changes in an individual’s mood, behavior, and language. We hypothesize that societies can undergo similar changes in their collective psychology that are reflected in historical records of language use. Here, we investigate the prevalence of textual markers of cognitive distortions in over 14 million books for the past 125 y and observe a surge of their prevalence since the 1980s, to levels exceeding those of the Great Depression and both World Wars. This pattern does not seem to be driven by changes in word meaning, publishing and writing standards, or the Google Books sample. Our results suggest a recent societal shift toward language associated with cognitive distortions and internalizing disorders.

Storytelling increases oxytocin and positive emotions, decreases cortisol and pain, in hospitalized kids

From Brockington et al.:

Storytelling is a distinctive human characteristic that may have played a fundamental role in humans’ ability to bond and navigate challenging social settings throughout our evolution. However, the potential impact of storytelling on regulating physiological and psychological functions has received little attention. We investigated whether listening to narratives from a storyteller can provide beneficial effects for children admitted to intensive care units. Biomarkers (oxytocin and cortisol), pain scores, and psycholinguistic associations were collected immediately before and after storytelling and an active control intervention (solving riddles that also involved social interaction but lacked the immersive narrative aspect). Compared with the control group, children in the storytelling group showed a marked increase in oxytocin combined with a decrease in cortisol in saliva after the 30-min intervention. They also reported less pain and used more positive lexical markers when describing their time in hospital. Our findings provide a psychophysiological basis for the short-term benefits of storytelling and suggest that a simple and inexpensive intervention may help alleviate the physical and psychological pain of hospitalized children on the day of the intervention.

We’ve been great at extending our lives, but not at ending them.

Steven Pinker does a review of Steven Johnson's recent book "Extra Life - A Short History of Living Longer," whose subject matter overlaps considerably with Chapters 5 ("Life") and 6 ("Health") of Pinker's book "Enlightenment Now" that MindBlog abstracted in a series of posts March 1-12, 2018.

Starting in the second half of the 19th century, the average life span began to climb rapidly, giving humans not just extra life, but an extra life. In rich countries, life expectancy at birth hit 40 by 1880, 50 by 1900, 60 by 1930, 70 by 1960, and 80 by 2010. The rest of the world is catching up. Global life expectancy in 2019 was 72.6 years, higher than that of any country, rich or poor, in 1950...Of the eight innovations that have saved the most lives, as Johnson sees it, six are defenses against infectious disease.

The sin of ingratitude is said to condemn one to the ninth circle of hell, and that’s where we may be headed for our attitudes toward the granters of extra life. In the list of inventions that saved lives by the hundreds of millions, we find antibiotics (squandered to fatten chickens in factory farms), blood transfusions (condemned as sinful by the devout), and chlorination and pasteurization (often mistrusted as unnatural). Among those that saved lives by the billions, we find the lowly toilet and sewer (metaphors for the contemptible), artificial fertilizer (a devil for Whole Foods shoppers) and vaccines (perhaps the greatest invention in history, and the target of head-smackingly stupid resistance).

Johnson shakes us out of our damnable ingratitude and explains features of modernity that are reviled by sectors of the right and left: government regulation, processed food, high-tech farming, big data and bureaucracies like the Food and Drug Administration, the Centers for Disease Control and Prevention and the World Health Organization. He is open about their shortcomings and dangers. But much depends on whether we see them as evils that must be abolished or as lifesavers with flaws that must be mitigated.

A New Yorker essay by Brooke Jarvis also reviews Johnson's book and recaps the story of extending our lives, but moves on to consider another goal that we have been much less clear on - attaining a good death - by reviewing Katie Engelhart’s “The Inevitable: Dispatches on the Right to Die," which describes the right-to-die underground, a world of people who ask why a medical system so good at extending their lives will do little to help them end those lives in a peaceful and painless way. She gives the stories of people who have managed their exit through using the manual "The Peaceful Pill Handbook."

In the United States, physician-assisted suicide is permitted in a slowly growing number of states, but only to ease the deaths of patients who fit a narrow set of legal criteria. Generally, they must have received a terminal diagnosis with a prognosis of six months or less; be physically able to administer the drugs to themselves; have been approved by doctors as mentally competent to make the decision; and have made a formal request more than once, including after a waiting period.

Doctors who specialize in aid in dying often distinguish between “despair suicides,” the most familiar version, and “rational suicides,” those sought by people who have, in theory, weighed a terminal or painful or debilitating diagnosis and made a measured, almost mathematical choice about how best to deal with it. In practice, though, Engelhart finds that it’s hard to isolate pure rationality; many emotional factors always seem to tilt the scales. People worry about their lives having a sense of narrative integrity and completion. They worry about autonomy, and about “dignity” (this is another word that comes up a lot, and when Engelhart digs in she finds that many people define it quite specifically: control over one’s own defecation and mess). They worry about what other people will think of them. They worry about who will take care of them when they can no longer take care of themselves.

Behind every fraught ethical debate about physician-assisted suicide stands this inescapable reality: there are many people for whom the way we do things is not working. The right to die can’t be extricated from a right to care. One of the doctors Engelhart interviews—an oncologist in Belgium, where euthanasia laws are widely supported, and aid in dying is legal even for psychiatric patients who request it and qualify—tells her that America is not ready for such laws. “It’s a developing country,” he says. “You shouldn’t try to implement a law of euthanasia in countries where there is no basic healthcare.”

The latest on wearable stress-relief

Over its 15 year history MindBlog has done several reviews of widgets currently on the market that are meant to monitor and relieve stress. Chiu has done a review of three current devices you might have a look at if you have $250-$350 to burn. It seems that most users find mild benefits when trying them, but don't feel a strong urge to continue using them. The online reviews offered by vendors are predictability ecstatic (placebo effects anyone?). There is no peer-reviewed research from large-scale clinical trials of their efficacy yet available. 

The Appolo Neuro is a slightly curved rectangular box on a band that can fit around wrist or ankle and issue "soothing vibrations that speak to your nervous system" to increase heart-rate variability during normal activity and sleep... Hmmmmm. The other widgets are used in sessions that are set aside from daily activities. The Sensate 2 looks like a smooth river rock that is placed on your chest during sessions and "combines vibrations, or “sonic frequencies,” synchronized with specially composed soundtracks to enhance relaxation." The Muse 2 is a meditation headband, which has built-in sensors monitor brain waves using “advanced signal processing” to translate brain waves into sounds of weather. 

I tried similar widgets 5-10 years ago. This time, I don't think I'm gonna go there....from Chin's article:  "most people don’t need wearables or technology to effectively manage stress,... Before investing in a device...why not try well-established, free approaches, such as spending time in nature, exercising, practicing mindfulness and cultivating social interactions.

Two promising post-traumatic stress disorder treatments

I want to pass on references to two new approaches to relieving the symptoms of post-traumatic stress disorder (PTSD). Nuwer describes a new study showing that MDMA (known as the party drug Ecstasy, or Molly) can bring relief to PTSD when used in conjunction with talk therapy. Ressler et al. address the problem that human patients cannot be directly re-exposed to trauma-cues of the sort that have been used in animal studies to induce and then disrupt reconsolidation of traumatic memories. They devise a procedure for covertly capturing and attenuating a hippocampu-dependent fear memory in male rats, a procedure that might prove to be useful in human therapy. Here is their abstract:

Reconsolidation may be a viable therapeutic target to inhibit pathological fear memories. In the clinic, incidental or imaginal reminders are used for safe retrieval of traumatic memories of experiences that occurred elsewhere. However, it is unknown whether indirectly retrieved traumatic memories are sensitive to disruption. Here we used a backward (BW) conditioning procedure to indirectly retrieve and manipulate a hippocampus (HPC)-dependent contextual fear engram in male rats. We show that conditioned freezing to a BW conditioned stimulus (CS) is mediated by fear to the conditioning context, activates HPC ensembles that can be covertly captured and chemogenetically activated to drive fear, and is impaired by post-retrieval protein synthesis inhibition. These results reveal that indirectly retrieved contextual fear memories reactivate HPC ensembles and undergo protein synthesis-dependent reconsolidation. Clinical interventions that rely on indirect retrieval of traumatic memories, such as imaginal exposure, may open a window for editing or erasure of neural representations that drive pathological fear.

A Dendrite-Focused Framework for Understanding the Actions of Ketamine and Psychedelics

I pass on the highlioght points from an interesting review (open source, with a useful graphic) of how the similar therapeutic effects of ketamine and psychedelics might be explained:

Ketamine can relieve symptoms of depression and anxiety, therefore filling a critically unmet psychiatric need. A few small-scale clinical studies suggest serotonergic psychedelics may have similar therapeutic effects.

Ketamine may both enhance and suppress dendritic excitability, through microcircuit interactions involving disinhibition.

Serotonergic psychedelics may both enhance and suppress excitability, through targeting coexpressed receptors.

Spatial mismatch in the opposing drug actions on dendritic excitability is predicted to steer plasticity actions towards certain synapses and cell types.

We present a dendrite-focused framework as a novel lens to view the actions of ketamine and serotonergic psychedelics on cortical circuits.

Brain mechanism by which testosterone reduces generosity

 Interesting work from Jianxin Ou et al.:

Significance

Testosterone is associated with aggressive behavior in both animals and humans. Here, we establish a link between increased testosterone and selfishness in economic decision making and identify the neural mechanisms through which testosterone reduces generosity in a double-blind, placebo-controlled, between-participant study. We find that testosterone induces more selfish choices, particularly when distant others are concerned. Moreover, it disrupts the representation of other-regarding value in local activity and functional connectivity involving the temporoparietal junction and subcortical regions involved in reward processing. Our study provides causal evidence for a testosterone-mediated neurohormonal link between generosity and the valuation system.

Abstract

Recent evidence has linked testosterone, a major sex hormone, to selfishness in economic decision-making. Here, we aimed to investigate the neural mechanisms through which testosterone reduces generosity by combining functional MRI with pharmacological manipulation among healthy young males in a double-blind, placebo-controlled, between-subject design. After testosterone or placebo gel administration, participants performed a social discounting task in which they chose between selfish options (benefiting only the participant) and generous options (providing also some benefit to another person at a particular social distance). At the behavioral level, testosterone reduced generosity compared to the placebo. At the neural level (n = 60), the temporoparietal junction (TPJ) encoded the other-regarding value of the generous option during generous choices, and this effect was attenuated by testosterone, suggesting that testosterone reduced the consideration of other’s welfare as underpinned by TPJ activity. Moreover, TPJ activity more strongly reflected individual differences in generosity in the placebo than the testosterone group. Furthermore, testosterone weakened the relation between the other-regarding value of generous decisions and connectivity between the TPJ and a region extending from the insula into the striatum. Together, these findings suggest that a network encompassing both cortical and subcortical components underpins the effects of testosterone on social preferences.