The sentient self

Diminished self-monitoring in hallucinations - Aberrant anterior insula connectivity differentiates auditory hallucinations in schizophrenia from subjective tinnitus

Auditory hallucinations in schizophrenia (SCZ-AH) and subjective tinnitus (TN) are two conditions that share a superficial resemblance, namely the presence of phantom sounds produced by the brain. A crucial difference between them lies in the self-processing of the phantom signals, which is intact in TN patients but lost in SCZ-AH. Our study sets out to investigate the potential neural mechanisms for this crucial psychotic symptom of SCZ-AH under the framework of self. We gathered resting-state fMRI data from three participant groups: SCZ-AH, TN and healthy controls. Focusing on predefined self-related regions-of-interest, we found that SCZ-AH had reduced degree centrality in the right anterior insula (rAI) compared to both TN and healthy controls. Further functional connectivity analysis showed a reduced connectivity between the rAI and right superior temporal gyrus. Our finding indicates that compromised self-processing in SCZ-AH could be due to aberrant connectivity in rAI, which interacted with the decreased connectivity between rAI and auditory cortex, and jointly contributed to the misattribution of the source of the phantom sound. Our findings provided preliminary evidence for the neural mechanism of self-disorder underlying SCZ-AH, and could provide implications for investigating other modalities of hallucinations in schizophrenia.

Dissociation as a disorder of integration - On the footsteps of Pierre Janet

At the end of the 19th century Pierre Janet described dissociation as an altered state of consciousness manifested in disrupted integration of psychological functions. Clinically, such disruption comprises compartmentalization symptoms like amnesia, detachment symptoms like depersonalization/derealization, and structural dissociation of personality with changes in the sense of self. The exact neuronal mechanisms leading to these different symptoms remain unclear. We here suggest to put Janet's original account of dissociation as disrupted integration of psychological functions into a novel context, that is, a neuronal context as related to current brain imaging. This requires a combined theoretical and empirical approach on data supporting such neuronal reframing of Janet. For that, we here review (i) past and (ii) recent psychological and neuronal views on dissociation together with neuroscientific theories of integration, which (iii) are supported and complemented by preliminary fMRI data. We propose three neuronal mechanisms of dynamic integration operating at different levels of the brain's spontaneous activity - temporo-spatial binding on the regional level, temporo-spatial synchronization on the network level, and temporo-spatial globalization on the global level. These neuronal mechanisms, in turn, may be related to different symptomatic manifestation of dissociation operating at different levels, e.g., compartmentalization, detachment, and structural, which, as we suggest, can all be traced to disrupted integration of neuronal and psychological functions as originally envisioned by Janet.

Do Process-1 simulations generate the epistemic feelings that drive Process-2 decision making?

We apply previously developed Chu space and Channel Theory methods, focusing on the construction of Cone-Cocone Diagrams (CCCDs), to study the role of epistemic feelings, particularly feelings of confidence, in dual process models of problem solving. We specifically consider "Bayesian brain" models of probabilistic inference within a global neuronal workspace architecture. We develop a formal representation of Process-1 problem solving in which a solution is reached if and only if a CCCD is completed. We show that in this representation, Process-2 problem solving can be represented as multiply iterated Process-1 problem solving and has the same formal solution conditions. We then model the generation of explicit, reportable subjective probabilities from implicit, experienced confidence as a simulation-based, reverse engineering process and show that this process can also be modeled as a CCCD construction.

Scale-free architectures support representational diversity

Gilead et al. propose an ontology of abstract representations based on folk-psychological conceptions of cognitive architecture. There is, however, no evidence that the experience of cognition reveals the architecture of cognition. Scale-free architectural models propose that cognition has the same computational architecture from sub-cellular to whole-organism scales. This scale-free architecture supports representations with diverse functions and levels of abstraction.

Classifying heterogeneous presentations of PTSD via the default mode, central executive, and salience networks with machine learning

Intrinsic connectivity networks (ICNs), including the default mode network (DMN), the central executive network (CEN), and the salience network (SN) have been shown to be aberrant in patients with posttraumatic stress disorder (PTSD). The purpose of the current study was to a) compare ICN functional connectivity between PTSD, dissociative subtype PTSD (PTSD+DS) and healthy individuals; and b) to examine the use of multivariate machine learning algorithms in classifying PTSD, PTSD+DS, and healthy individuals based on ICN functional activation. Our neuroimaging dataset consisted of resting-state fMRI scans from 186 participants [PTSD (n = 81); PTSD + DS (n = 49); and healthy controls (n = 56)]. We performed group-level independent component analyses to evaluate functional connectivity differences within each ICN. Multiclass Gaussian Process Classification algorithms within PRoNTo software were then used to predict the diagnosis of PTSD, PTSD+DS, and healthy individuals based on ICN functional activation. When comparing the functional connectivity of ICNs between PTSD, PTSD+DS and healthy controls, we found differential patterns of connectivity to brain regions involved in emotion regulation, in addition to limbic structures and areas involved in self-referential processing, interoception, bodily self-consciousness, and depersonalization/derealization. Machine learning algorithms were able to predict with high accuracy the classification of PTSD, PTSD+DS, and healthy individuals based on ICN functional activation. Our results suggest that alterations within intrinsic connectivity networks may underlie unique psychopathology and symptom presentation among PTSD subtypes. Furthermore, the current findings substantiate the use of machine learning algorithms for classifying subtypes of PTSD illness based on ICNs.

BNST-insula structural connectivity in humans

The bed nucleus of the stria terminalis (BNST) is emerging as a critical region in multiple psychiatric disorders including anxiety, PTSD, and alcohol and substance use disorders. In conjunction with growing knowledge of the BNST, an increasing number of studies examine connections of the BNST and how those connections impact BNST function. The importance of this BNST network is highlighted by rodent studies demonstrating that projections from other brain regions regulate BNST activity and influence BNST-related behavior. While many animal and human studies replicate the components of the BNST network, to date, structural connections between the BNST and insula have only been described in rodents and have yet to be shown in humans. In this study, we used probabilistic tractography to examine BNST-insula structural connectivity in humans. We used two methods of dividing the insula: 1) anterior and posterior insula, to be consistent with much of the existing insula literature; and 2) eight subregions that represent informative cytoarchitectural divisions. We found evidence of a BNST-insula structural connection in humans, with the strongest BNST connectivity localized to the anteroventral insula, a region of agranular cortex. BNST-insula connectivity differed by hemisphere and was moderated by sex. These results translate rodent findings to humans and lay an important foundation for future studies examining the role of BNST-insula pathways in psychiatric disorders.

The Self and its World: A Neuro-Ecological and Temporo-Spatial Account of Existential Fear

The current international crisis situation caused by the COVID-19 pandemic is having a strong psychological impact on our subjectivities. We are constantly threatened by the danger of i) being infected, ii) infecting other people, and (iii) by the loss of social relation. Departing from these premises, we here aim to investigate the psychological and neurodynamics of this complex phenomenon. First, we discuss about recent psychological and neuronal findings on fear and its disorders, related to an unbalanced intero-exteroceptive processing and emotional regulation. Secondly we move to the psychological and neuronal dynamics of self and others characterized by a temporo-spatial alignment with the world. Due to the neural overlap of emotion and self and the deep-reaching neuro-ecological layers of self, emotional feelings like fear and anxiety cannot be detached and dissociated from the world; they signify the world–brain relation, and, more specifically, our self-other relation. The deepest neuro-ecological and neuro-social layers of self are threatened by the loss of subjectivity, which is manifest in our loss of body and thus the fear of dying, and the loss of intersubjectivity that surfaces in our fear of infecting others, which reflect the intimate anchorage of the self with the world. In our opinion the pandemic of COVID-19 deeply affect our sense of self and its spatio-temporal neuronal dynamics providing the prerequisites for the manifestation of fear and existential anxiety, thus disrupting the brain-world relation with significant repercussions on our psyche and on our daily lives.

Aberrant interhemispheric functional connectivity in first-episode, drug-naïve major depressive disorder

Many studies have indicated that depression is associated with impairment of the topological organization of the brain functional network, which may lead to disruption of mood and cognition in depressive patients. The abnormality of homotopic connectivity provides a basis for the clinical manifestations of depression, such as emotional and cognitive disorders. Several studies have investigated the abnormal imbalance of homotopic regions between the hemispheres in depressive patients. However, the reported findings are inconsistent. Additionally, the published studies have focused on only the grey matter when investigating functional connectivity abnormalities of the bilateral cerebral hemispheres in major depressive disorder (MDD). The aim of this study is to investigate functional connectivity abnormalities of the bilateral cerebral hemispheres in patients with first-episode, drug-naïve MDD using a voxel-mirrored homotopic connectivity (VMHC) method. Based on DSM-IV diagnostic criteria, 23 first-episode, drug-naïve MDD patients were recruited, together with 20 gender- and age-matched healthy normal controls. A Philips Achieva 3.0 T MRI scanner was used to acquire brain functional images at resting state as well as high-resolution structural images. The functional images were preprocessed by using Data Processing Assistant for Resting-State Functional MR Imaging toolkit and SPM8.VMHC between the bilateral hemispheres was computed and compared between the MDD and control groups. The correlation between the VMHC values of the abnormal homotopy function areas and the Hamilton Depression Rating Scale (HAMD) was evaluated in the MDD patients. Compared with the control group, the MDD patients showed significantly decreased VMHC values in the bilateral brain regions including the insular, putamen, and frontal white matter. The MDD patients did not exhibit increased VMHC values in any brain regions compared with the normal controls. In addition, a negative correlation was observed between the VMHC value in the frontal lobe white-matter and the HAMD in the MDD patients. Abnormalities in brain homotopic functional connectivity observed in this study may indicate abnormal neural circuits related to aberrant cognition and emotional processing in MDD. Although the physiological significance underlaying abnormal VMHC in white matter in the frontal lobe needs further research, our study new angle to investigate the role of white-matter abnormalities in MDD as well as other psychiatric disorders.

Damage to the right insula disrupts the perception of affective touch

Specific, peripheral C-tactile afferents contribute to the perception of tactile pleasure, but the brain areas involved in their processing remain debated. We report the first human lesion study on the perception of C-tactile touch in right hemisphere stroke patients (N = 59), revealing that right posterior and anterior insula lesions reduce tactile, contralateral and ipsilateral pleasantness sensitivity, respectively. These findings corroborate previous imaging studies regarding the role of the posterior insula in the perception of affective touch. However, our findings about the crucial role of the anterior insula for ipsilateral affective touch perception open new avenues of enquiry regarding the cortical organization of this tactile system.

Anxiety Disorders and the Brain's Resting State Networks: From Altered Spatiotemporal Synchronization to Psychopathological Symptoms

Anxiety disorders include a variety of different disorders including panic disorder (PD), social anxiety disorder (SAD), generalized anxiety disorder (GAD), and phobias. We here focus our review on GAD, SAD, and PD and put a specific emphasis on resting state networks and the coupling between the brain and the heart as all anxiety disorders exhibit abnormal perception of their own heartbeat in some way or the other. Resting state functional connectivity (rsFC) studies demonstrate abnormalities in default-mode network (DMN) in all anxiety disorders, e.g., mostly decreases in rsFC of DMN. In contrast, resting state fMRI shows increased rsFC in salience network (SN) (SAD, GAD) and/or somato-motor/sensory network (SMN) (PD). Since rsFC is coherence- or phase-based operating in the infraslow frequency domain (0.01-0.1 Hz), these data suggest spatiotemporal hypo- or hyper-synchronization in DMN and SMN/SN, respectively. These abnormalities in the neural network's spatiotemporal synchronization may, in turn, impact phase-based temporal synchronization of neural and cardiac activities resulting in decreased (DMN) or increased (SMN/SN) neuro-cardiac coupling in anxiety disorders. That, in turn, may be related to the various psychopathological symptoms like unstable sense of self (as based on unstable DMN showing spatiotemporal hypo-synchronization), increased emotions and specifically anxiety (as related to increased SN showing spatiotemporal hyper-synchronization), and increased bodily awareness (mediated by increased SMN with spatiotemporal hyper-synchronization) in anxiety disorders. Taken together, we here suggest altered spatiotemporal synchronization of neural and cardiac activity within the brain's resting state to underlie various psychopathological symptoms in anxiety disorders. Such spatiotemporal basis of psychopathological symptoms is well compatible with the recently suggested "Spatiotemporal Psychopathology."

Neural Systems for Own-body Processing Align with Gender Identity Rather Than Birth-assigned Sex

Gender identity is a core aspect of self-identity and is usually congruent with birth-assigned sex and own body sex-perception. The neuronal circuits underlying gender identity are unknown, but greater awareness of transgenderism has sparked interest in studying these circuits. We did this by comparing brain activation and connectivity in transgender individuals (for whom gender identity and birth-assigned sex are incongruent) with that in cisgender controls (for whom they are congruent) when performing a body self-identification task during functional magnetic resonance imaging. Thirty transgender and 30 cisgender participants viewed images of their own bodies and bodies morphed in sex toward or opposite to birth-assigned sex, rating each image to the degree they identified with it. While controls identified with images of themselves, transgender individuals identified with images morphed "opposite" to their birth-assigned sex. After covarying out the effect of self-similarity ratings, both groups activated similar self- and body-processing systems when viewing bodies that aligned with their gender identity rather than birth-assigned sex. Additionally, transgender participants had greater limbic involvement when viewing ambiguous, androgynous images of themselves morphed toward their gender identity. These results shed light on underlying self-processing networks specific to gender identity and uncover additional involvement of emotional processing in transgender individuals.

The Neural Correlates of Consciousness and Attention: Two Sister Processes of the Brain

During the last three decades our understanding of the brain processes underlying consciousness and attention has significantly improved, mainly because of the advances in functional neuroimaging techniques. Still, caution is needed for the correct interpretation of these empirical findings, as both research and theoretical proposals are hampered by a number of conceptual difficulties. We review some of the most significant theoretical issues concerning the concepts of consciousness and attention in the neuroscientific literature, and put forward the implications of these reflections for a coherent model of the neural correlates of these brain functions. Even though consciousness and attention have an overlapping pattern of neural activity, they should be considered as essentially separate brain processes. The contents of phenomenal consciousness are supposed to be associated with the activity of multiple synchronized networks in the temporo-parietal-occipital areas. Only subsequently, attention, supported by fronto-parietal networks, enters the process of consciousness to provide focal awareness of specific features of reality.

A Neurobehavioral Approach to Addiction: Implications for the Opioid Epidemic and the Psychology of Addiction

Two major questions about addictive behaviors need to be explained by any worthwhile neurobiological theory. First, why do people seek drugs in the first place? Second, why do some people who use drugs seem to eventually become unable to resist drug temptation and so become "addicted"? We will review the theories of addiction that address negative-reinforcement views of drug use (i.e., taking opioids to alleviate distress or withdrawal), positive-reinforcement views (i.e., taking drugs for euphoria), habit views (i.e., growth of automatic drug-use routines), incentive-sensitization views (i.e., growth of excessive "wanting" to take drugs as a result of dopamine-related sensitization), and cognitive-dysfunction views (i.e., impaired prefrontal top-down control), including those involving competing neurobehavioral decision systems (CNDS), and the role of the insula in modulating addictive drug craving. In the special case of opioids, particular attention is paid to whether their analgesic effects overlap with their reinforcing effects and whether the perceived low risk of taking legal medicinal opioids, which are often prescribed by a health professional, could play a role in the decision to use. Specifically, we will address the issue of predisposition or vulnerability to becoming addicted to drugs (i.e., the question of why some people who experiment with drugs develop an addiction, while others do not). Finally, we review attempts to develop novel therapeutic strategies and policy ideas that could help prevent opioid and other substance abuse.

Working With the Predictable Life of Patients: The Importance of "Mentalizing Interoception" to Meaningful Change in Psychotherapy

To understand our patients and optimize their treatment, psychotherapists of all theoretical orientations may benefit from considering current scientific evidence alongside psychodynamic constructs. There is recent neuroscientific evidence that subjective awareness, feelings and emotions depend upon "interoception," defined as the neural signaling to the brain from all tissues of the body. Interoception is the obvious basis of homeostasis (in the brainstem) but some interoceptive signals rise above this level and contribute to inferential processes that substantiate intrapersonal and interpersonal experience. The focus of this paper is on the essential role that their "interoception" plays in our patients' emotional experience and subjective awareness, and how the process referred to as "mentalizing interoception" may be harnessed in therapy. This can best be understood in terms of "predictive processing," which describes how subjective states, and particularly emotion, are inferred from sensory inputs - both interoceptive and exteroceptive. Predictive processing assumes that the brain infers (probabilistically) the likely cause of sensation experienced through the sense organs, by testing this sensory data against its innate and learned "priors." This implies that any effort at changing heavily over-learned prior beliefs will require action upon the system that has generated that set of prior beliefs. This involves, quite literally, acting upon the world to alter inferential processes, or in the case of interoceptive priors, acting on the patient's body to alter habitual autonomic nervous system (ANS) reflexes. Focused attention to bodily sensations/reactions, in the safety of the therapeutic relationship, provides a route to "mentalizing interoception," by means of the bodily cues that may be the only conscious element of deeply hidden priors and thus the clearest way to access them. This can: update patients' characteristic, dysfunctional responses to emotion and feelings; increase emotional insight; decrease cognitive distortions; and engender a more acute awareness of the present moment. These important ideas are outlined below from the perspective of psychodynamic psychotherapeutic practice, in order to discuss how relevant information from neuroscientific theory and current research can best be applied in clinical treatment. A clinical case will be presented to illustrate how this argument or treatment relates directly to clinical practice.

Psychoanalysis and Neuroscience: The Bridge Between Mind and Brain

In 1895 in the Project for a Scientific Psychology, Freud tried to integrate psychology and neurology in order to develop a neuroscientific psychology. Since 1880, Freud made no distinction between psychology and physiology. His papers from the end of the 1880s to 1890 were very clear on this scientific overlap: as with many of his contemporaries, Freud thought about psychology essentially as the physiology of the brain. Years later he had to surrender, realizing a technological delay, not capable of pursuing its ambitious aim, and until that moment psychoanalysis would have to use its more suitable clinical method. Also, he seemed skeptical about phrenology drift, typical of that time, in which any psychological function needed to be located in its neuroanatomical area. He could not see the progresses of neuroscience and its fruitful dialogue with psychoanalysis, which occurred also thanks to the improvements in the field of neuroimaging, which has made possible a remarkable advance in the knowledge of the mind-brain system and a better observation of the psychoanalytical theories. After years of investigations, deriving from research and clinical work of the last century, the discovery of neural networks, together with the free energy principle, we are observing under a new light psychodynamic neuroscience in its exploration of the mind-brain system. In this manuscript, we summarize the important developments of psychodynamic neuroscience, with particular regard to the free energy principle, the resting state networks, especially the Default Mode Network in its link with the Self, emphasizing our view of a bridge between psychoanalysis and neuroscience. Finally, we suggest a discussion by approaching the concept of Alpha Function, proposed by the psychoanalyst Wilfred Ruprecht Bion, continuing the association with neuroscience.

Prediction-based neural mechanisms for shielding the self from existential threat

The human mind has an automatic tendency to avoid awareness of its mortality. How this protective mechanism is implemented at the neuronal level is unknown. Here we test the hypothesis that prediction-based mechanisms mediate death-denial by shielding the self from existential threat. We provide evidence that self-specific predictive processes are downregulated during the perception of death-related linguistic stimuli and that this mechanism can predict fear-of-death. Using a magnetoencephalography visual mismatch paradigm, we show that the brain's automatic prediction response to deviancy is eliminated when death words and self-face representations are coupled, but remains present when coupled to other-face or to negative words. We further demonstrate a functional link between how death impacts self-image vs. Other-image, and show that it predicts fear-of-death. Finally, we confirm this effect in a behavioral active inference experiment showing that death-related words bias perceptual judgment on facial self and other morphed video clips. Together these results lay out, for the first time, a plausible neural-based mechanism of death-denial.

Implications of insular cortex laterality for treatment of nicotine addiction

BACKGROUND

Damage to the insula disrupts nicotine-induced cravings and is associated with greater odds of cessation. The role of laterality in regulating these changes is unclear. Neuroimaging studies in cigarette smokers show left hemispheric activation during a period of forced withdrawal and right hemispheric activation after having just smoked. Among current smokers hospitalized for stroke involving their insula, we compared left versus right insular damage and its effect on smoking outcomes.

METHODS

A total of 37 smokers hospitalized with unilateral insular strokes (14 right, 23 left) were administered questionnaires to assess urge (Questionnaire on Smoking Urges) before (retrospectively) and during hospitalization and 3 months post-stroke, withdrawal during hospitalization (Wisconsin Smoking Withdrawal Scale), and prolonged abstinence at 3 months post-stroke. Crude and adjusted linear regression models were performed controlling for baseline covariates.

RESULTS

Right and left insular-damaged smokers experienced a significant decrease in urge from baseline to hospitalization and three-month follow-up (p < 0.01). Smokers with left-sided insular infarcts relative to right-sided experienced a larger decrease in acute urge (adjusted β=-1.16, 95% CI: -2.59, 0.27, p = 0.11) but not chronically (adjusted β=-0.06, 95% CI: -1.53, 1.40, p = 0.93). Left-sided insular damage was also associated with significantly fewer and less severe withdrawal symptoms during hospitalization (adjusted β=-3.52, 95% CI: -7.01, -0.04, p = 0.05). No differences were noted between groups for prolonged abstinence (p = 0.50).

CONCLUSIONS

Left insular adaptations are suggestive to have an impact on acute changes in urge and withdrawal more so than the right insula, however lateral asymmetries did not exist for long-term changes.

Subjectivity "Demystified": Neurobiology, Evolution, and the Explanatory Gap

While life in general can be explained by the mechanisms of physics, chemistry, and biology, to many scientists and philosophers, it appears that when it comes to explaining consciousness, there is what the philosopher Joseph Levine called an "explanatory gap" between the physical brain and subjective experiences. Here, we deduce the living and neural features behind primary consciousness within a naturalistic biological framework, identify which animal taxa have these features (the vertebrates, arthropods, and cephalopod molluscs), then reconstruct when consciousness first evolved and consider its adaptive value. We theorize that consciousness is based on all the complex system features of life, plus even more complex features of elaborate brains. We argue that the main reason why the explanatory gap between the brain and experience has been so refractory to scientific explanation is that it arises from both life and from varied and diverse brains and brain regions, so bridging the gap requires a complex, multifactorial account that includes the great diversity of consciousness, its personal nature that stems from embodied life, and the special neural features that make consciousness unique in nature.

Insula serotonin 2A receptor binding and gene expression contribute to serotonin transporter polymorphism anxious phenotype in primates

Genetic variation in the serotonin transporter gene (SLC6A4) is associated with vulnerability to affective disorders and pharmacotherapy efficacy. We recently identified sequence polymorphisms in the common marmoset SLC6A4 repeat region (AC/C/G and CT/T/C) associated with individual differences in anxiety-like trait, gene expression, and response to antidepressants. The mechanisms underlying the effects of these polymorphisms are unknown, but a key mediator of serotonin action is the serotonin 2A receptor (5HT_2A). Thus, we correlated 5HT_2A binding potential (BP) and RNA gene expression in 16 SLC6A4 genotyped marmosets with responsivity to 5HT_2A antagonism during the human intruder test of anxiety. Voxel-based analysis and RNA measurements showed a reduction in 5HT_2A BP and gene expression specifically in the right posterior insula of individuals homozygous for the anxiety-related variant AC/C/G. These same marmosets displayed an anxiogenic, dose-dependent response to the human intruder after 5HT_2A pharmacological antagonism, while CT/T/C individuals showed no effect. A voxel-based correlation analysis, independent of SLC6A4 genotype, revealed that 5HT_2A BP in the adjacent right anterior insula and insula proisocortex was negatively correlated with trait anxiety scores. Moreover, 5HT_2A BP in both regions was a good predictor of the size and direction of the acute emotional response to the human intruder threat after 5HT_2A antagonism. Our findings suggest that genetic variation in the SLC6A4 repeat region may contribute to the trait anxious phenotype via neurochemical changes in brain areas implicated in interoceptive and emotional processing, with a critical role for the right insula 5HT_2A in the regulation of affective responses to threat.

Resting-State Functional Connectivity Between Centromedial Amygdala and Insula as Related to Somatic Symptoms in Depressed Patients: A Preliminary Study

OBJECTIVE

Somatic symptoms are prevalent in patients with depression. The centromedial amygdala (CMA) is a key brain region that mediates autonomic and somatic responses. Abnormal function in the CMA may contribute to the development of somatic symptoms in depressed patients.

METHODS

We compared the resting-state functional connectivity (RSFC) based on the seed of the left and right CMA between 37 patients with depression and 30 healthy controls. The severity of depressive and somatic symptoms was assessed using the Hamilton Depression Rating Scale (HDRS) and the 15-item somatic symptom severity scale of the Patient Health Questionnaire (PHQ-15). Correlation analysis was performed to investigate the relationship between the RSFC and clinical variables (HDRS and PHQ-15) in depressed patients.

RESULTS

Compared with healthy controls, patients with depression exhibited decreased RSFC between the CMA and insula, and superior temporal gyrus. In addition, functional connectivity between the left CMA and left insula was negatively correlated with PHQ-15 (r = -0.348, p = .037) in depressed patients. No significant relation was found between the RSFC and HDRS in depressed patients.

CONCLUSIONS

Functional connectivity between the CMA and insula is reduced in depressive patients, which is associated with the severity of somatic symptoms. Our findings may provide a potential neural substrate to interpret the co-occurrence of depression with somatic symptoms.

Adaptive systems influence both learning and conscious attention

The scientific study of animal behavior had its beginnings in two separate scientific traditions. Adaptive explanations, as expanded by ethological studies of natural behavior, emphasized that behavioral traits were guided by innately organized stimulus and response dispositions. Associative explanations, as expanded by conditioning studies, emphasized that behavior was shaped by learned connections formed between stimuli, responses, and motivational outcomes. When William Timberlake began his career as a learning psychologist, he adopted a behavior systems approach that helped to reconcile the different emphases of these two traditions. Behavior systems argued that pre-organized adaptive dispositions also contribute to learning. They bias what stimulus and response features are most likely to be engaged and influence patterns of behavioral expression during conditioning. The first half of this paper surveys Timberlake's early research and highlights some of his many explanations of conditioning outcomes using this approach. The second section of this paper describes my extension of this approach to reconcile differences between adaptive and associative accounts of consciousness. It argues that pre-organized biological dispositions for attention contribute to conscious awareness. These "attention systems" bias what topics are most likely to be noticed and influence the affective dispositions that are activated during conscious attention.

The Functional Network Processing Acute Electrical Itch Stimuli in Humans

The posterior insula (pIns) is a major brain region that receives itch-related signals from the periphery and transfers these signals to broad areas in the brain. Previous brain imaging studies have successfully identified brain regions that respond to itch stimuli. However, it is still unknown which brain regions receive and process itch-related signals from the pIns. Addressing this question is important in identifying key functional networks that process itch. Thus, the present study investigated brain regions with significantly increased functional connectivity with the pIns during itch stimuli with 25 healthy subjects by using functional MRI. Electrical itch stimuli was applied to the left wrist. Similar to previous brain imaging studies, many cortical and subcortical areas were activated by itch stimuli. However, not all of these regions showed significant increments of functional connectivity with the pIns during itch stimuli. While the subjects perceived the itch sensation, functional connectivity was significantly increased between the right pIns and the supplementary motor area (SMA), pre-SMA, anterior midcingulate cortex (aMCC), anterior insula (aIns), secondary somatosensory cortex (SII), and basal ganglia (BG), suggesting that this is a key network in processing itch. In particular, intensity of functional connectivity between the pIns and BG was negatively correlated with itch rating. The functional pIns-BG pathway may play an important role in regulation of subjective itch sensation. This study first identified a key brain network to process itch.

The Organization of the Primate Insular Cortex

Long perceived as a primitive and poorly differentiated brain structure, the primate insular cortex recently emerged as a highly evolved, organized and richly connected cortical hub interfacing bodily states with sensorimotor, environmental, and limbic activities. This insular interface likely substantiates emotional embodiment and has the potential to have a key role in the interoceptive shaping of cognitive processes, including perceptual awareness. In this review, we present a novel working model of the insular cortex, based on an accumulation of neuroanatomical and functional evidence obtained essentially in the macaque monkey. This model proposes that interoceptive afferents that represent the ongoing physiological status of all the organs of the body are first being received in the granular dorsal fundus of the insula or “primary interoceptive cortex,” then processed through a series of dysgranular poly-modal “insular stripes,” and finally integrated in anterior agranular areas that serve as an additional sensory platform for visceral functions and as an output stage for efferent autonomic regulation. One of the agranular areas hosts the specialized von Economo and Fork neurons, which could provide a decisive evolutionary advantage for the role of the anterior insula in the autonomic and emotional binding inherent to subjective awareness.

Anterior insular cortex plays a critical role in interoceptive attention

Accumulating evidence indicates that the anterior insular cortex (AIC) mediates interoceptive attention which refers to attention towards physiological signals arising from the body. However, the necessity of the AIC in this process has not been demonstrated. Using a novel task that directs attention toward breathing rhythm, we assessed the involvement of the AIC in interoceptive attention in healthy participants using functional magnetic resonance imaging and examined the necessity of the AIC in interoceptive attention in patients with AIC lesions. Results showed that interoceptive attention was associated with increased AIC activation, as well as enhanced coupling between the AIC and somatosensory areas along with reduced coupling between the AIC and visual sensory areas. In addition, AIC activation was predictive of individual differences in interoceptive accuracy. Importantly, AIC lesion patients showed disrupted interoceptive discrimination accuracy and sensitivity. These results provide compelling evidence that the AIC plays a critical role in interoceptive attention.

Sex differences in insular functional connectivity in response to noxious visceral stimulation in rats

Insular cortex (INS) plays a critical role in pain processing and shows sex differences in functional activation during noxious visceral stimulation. Less is known regarding functional interactions within the INS and between this structure and other parts of the brain. Cerebral blood flow mapping was performed using [¹⁴C]-iodoantipyrine perfusion autoradiography in male and female rats during colorectal distension (CRD) or no distension (controls). Forty regions of interest (ROIs) were defined anatomically to represent the granular, dysgranular, and agranular INS along the anterior-posterior (A-P) axis. Inter-ROI correlation matrices were calculated for each group to characterize intra-insular functional connectivity (FC). Results showed a clear FC segregation within the INS into an anterior (rostral to bregma +2.4 mm), a posterior (caudal to bregma -1.2 mm), and a mid INS subregion in between. Female controls showed higher FC density compared to males. During CRD, intra-insular FC density decreased greatly in females, but only modestly in males, with a loss of long-range connections between the anterior and mid INS noted in both sexes. New functional organization was characterized in both sexes by a cluster in the mid INS and primarily short-range FC along the A-P axis. Seed correlation analysis during CRD showed sex differences in FC of the anterior and mid agranular INS with the medial prefrontal cortex, thalamus, and brainstem areas (periaqueductal gray, parabrachial nucleus), suggesting sex differences in the modulatory aspect of visceral pain processing. Our findings suggest presence of substantial sex differences in visceral pain processing at the level of the insula.

Increased recruitment of cognitive control in the presence of traumatic stimuli in complex PTSD

A neurocircuitry model of post-traumatic stress disorder (PTSD) suggests increased amygdala responses to emotional stimuli, coupled with hypoactivation of prefrontal regions associated with cognitive control. However, results are heterogenous across different subsamples of PTSD as well as different paradigms. We investigated cognitive control in a classic and emotional Stroop task in 28 female patients with complex PTSD (cPTSD), 28 female trauma-exposed healthy controls (TCs) and 28 female non-trauma-exposed healthy controls (HCs) using functional neuroimaging. Afterwards, we assessed memory function in a spontaneous free recall and recognition task. Patients with cPTSD displayed significantly greater Stroop interference with trauma-related words (as reflected in slower reaction times and increased errors) compared to the other conditions and compared to the TC and HC groups. Moreover, patients with cPTSD showed increased activation in the context of trauma-related words in brain regions associated with cognitive control (dlPFC, vmPFC, dACC) compared to both control groups, and a trend for increased activation in the insula compared to the HC group. Increased recruitment of regions contributing to cognitive control in patients with cPTSD, together with a lack of amygdala response may point to efforts to compensate for emotional distraction caused by the trauma-related words.

Aberrations of anterior insular cortex functional connectivity in nontreatment-seeking alcoholics

An emergent literature suggests that resting state functional magnetic resonance imaging (rsfMRI) functional connectivity (FC) patterns are aberrant in alcohol use disorder (AUD) populations. The salience network (SAL) is an established set of brain regions prominent in salience attribution and valuation, and includes the anterior insular cortex (AIC). The SAL is thought to play a role in AUD through directing increased attention to interoceptive cues of intoxication. There is very little information on the salience network (SAL) in AUD, and, in particular, there are no data on SAL FC in currently drinking, nontreatment seeking individuals with AUD (NTS). rsfMRI data from 16 NTS and 21 social drinkers (SD) were compared using FC correlation maps from ten seed regions of interest in the bilateral AIC. As anticipated, SD subjects demonstrated greater insular FC with frontal and parietal regions. We also found that, compared to SD, NTS had higher insular FC with hippocampal and medial orbitofrontal regions. The apparent overactivity in brain networks involved in salience, learning, and behavioral control in NTS suggests possible mechanisms in the development and maintenance of AUD.

Noninvasive vagus nerve stimulation alters neural response and physiological autonomic tone to noxious thermal challenge

The mechanisms by which noninvasive vagal nerve stimulation (nVNS) affect central and peripheral neural circuits that subserve pain and autonomic physiology are not clear, and thus remain an area of intense investigation. Effects of nVNS vs sham stimulation on subject responses to five noxious thermal stimuli (applied to left lower extremity), were measured in 30 healthy subjects (n = 15 sham and n = 15 nVNS), with fMRI and physiological galvanic skin response (GSR). With repeated noxious thermal stimuli a group × time analysis showed a significantly (p < .001) decreased response with nVNS in bilateral primary and secondary somatosensory cortices (SI and SII), left dorsoposterior insular cortex, bilateral paracentral lobule, bilateral medial dorsal thalamus, right anterior cingulate cortex, and right orbitofrontal cortex. A group × time × GSR analysis showed a significantly decreased response in the nVNS group (p < .0005) bilaterally in SI, lower and mid medullary brainstem, and inferior occipital cortex. Finally, nVNS treatment showed decreased activity in pronociceptive brainstem nuclei (e.g. the reticular nucleus and rostral ventromedial medulla) and key autonomic integration nuclei (e.g. the rostroventrolateral medulla, nucleus ambiguous, and dorsal motor nucleus of the vagus nerve). In aggregate, noninvasive vagal nerve stimulation reduced the physiological response to noxious thermal stimuli and impacted neural circuits important for pain processing and autonomic output.

Spontaneous Brain Activity Predicts Task-Evoked Activity During Animate Versus Inanimate Touch

The spontaneous activity of the brain is characterized by an elaborate temporal structure with scale-free properties as indexed by the power law exponent (PLE). We test the hypothesis that spontaneous brain activity modulates task-evoked activity during interactions with animate versus inanimate stimuli. For this purpose, we developed a paradigm requiring participants to actively touch either animate (real hand) or inanimate (mannequin hand) stimuli. Behaviorally, participants perceived the animate target as closer in space, temporally more synchronous with their own self, and more personally relevant, compared with the inanimate. Neuronally, we observed a modulation of task-evoked activity by animate versus inanimate interactions in posterior insula, in medial prefrontal cortex, comprising anterior cingulate cortex, and in medial superior frontal gyrus. Among these regions, an increased functional connectivity was shown between posterior insula and perigenual anterior cingulate cortex (PACC) during animate compared with inanimate interactions and during resting state. Importantly, PLE during spontaneous brain activity in PACC correlated positively with PACC task-evoked activity during animate versus inanimate stimuli. In conclusion, we demonstrate that brain spontaneous activity in PACC can be related to the distinction between animate and inanimate stimuli and thus might be specifically tuned to align our brain with its animate environment.

Signatures of alcohol use in the structure and neurochemistry of insular cortex: a correlational study

RATIONALE

Insular cortex supports the representation of motivational feelings through the integration of interoceptive information concerning bodily physiology. Compromised insular integrity is implicated in alcohol and drug use disorders. Alcohol-associated insular dysfunction may arise through aberrant glutamatergic neurotransmission associated with selective neuronal death and atrophy.

OBJECTIVE

In a sample of alcohol users, we combined magnetic resonance spectroscopy (MRS) with voxel and surface-based morphometry (VBM, SBM) to test the hypothesis that the neurochemical and structural properties of the insula relate to alcohol use.

METHODS

Twenty-three healthy individuals were characterized by measures of alcohol use and subjective craving. Right mid-insula glutamate/glutamine (Glx) and total N-acetylaspartate/N-acetyl-aspartylglutamate (TNAA) concentrations were measured using MRS. Right insular structure was quantified using VBM and SBM parameters. We tested for predictive associations between these neuroimaging and behavioral/psychometric measures using Bayesian statistics.

RESULTS

Reduced insular Glx concentration was associated with increased alcohol compulsions and, to a lesser extent, with greater alcohol use severity. Anecdotal evidence for a negative relationship between alcohol use severity and levels of insular gyrification was also observed.

CONCLUSIONS

This study is, to date, the first characterization of the neurochemical and morphological integrity of insular cortex in alcohol users. Our data seem to reveal a negative relationship between alcohol use and the neurochemical and structural integrity of the insula, a critical substrate for motivational behavior. These neurobiological characteristics might contribute to loss of control toward compulsive drinking with prolonged and excessive alcohol use.

The Optical-Coenaesthetic Disproportion Hypothesis of Feeding and Eating Disorders in the Light of Neuroscience

This article builds on and extends the 'optical-coenaesthetic disproportion' (OCDisp) hypothesis of feeding and eating disorders (FEDs) matching data obtained through clinical research with laboratory evidence from neuroscience and neuropsychological studies. The OCDisp hypothesis, developed through the assessment in clinical setting of bodily experience using the IDentity and EAting (IDEA) disorder questionnaire, argues that in persons with FED the internal perception of one's embodied self (i.e., coenaesthesia) is deeply affected (their possibility to feel themselves is weakened or threatened by coenaesthopathic and emotional paroxysms; their bodily feelings are discontinuous over time), and as a compensation to it, these persons experience their own body as an object that is looked at by others. To FED persons, their body is principally given to them as an object 'to be seen.' The other's look serves as an optical prosthesis to cope with hypo- and dis-coenaesthesia and as a device through which persons with FED can define themselves and attenuate the anxiety produced by the conflicts between being-oneself and being-for-others. After describing the OCDisp hypothesis, we will gather evidence supporting it with neuroscience studies on FED. Our focus will be on data pointing to dampened multisensory integration of interoceptive and esteroceptive signals, demonstrating a predominance of the visual afferents toward signals arising within the body. In the final part of the article, we will show consistencies but also draw distinctions between our clinical hypothesis and neuroscience-based data and hypotheses and draft a potential agenda for translational research inspired by these.

A historical review of investigations on laterality of emotions in the human brain

Different models of emotional lateralization, advanced since the first clinical observations raised this issue, will be reviewed following their historical progression. The clinical investigations that have suggested a general dominance of the right hemisphere for all kinds of emotions and the experimental studies that have proposed a different hemispheric specialization for positive vs. negative emotions (valence hypothesis) or for approach vs. withdrawal tendencies (motivational hypothesis) will be reviewed first and extensively. This historical review will be followed by a short discussion of recent anatomo-clinical and activation studies that have investigated (a) emotional and behavioral disorders of patients with asymmetrical forms of fronto-temporal degeneration and (b) laterality effects in specific brain structures (amygdala, ventro-medial prefrontal cortex, and anterior insula) playing a critical role in different components of emotions. Overall, these studies support the hypothesis of a right hemisphere dominance for all components of the emotional system.

The Altered Somatic Brain Network in State Anxiety

Highly anxious individuals often show excessive emotional arousal, somatic arousal, and characteristics of mental illness. Previous researches have extensively investigated the emotional and cognitive biases of individuals with high anxiety, but overlooked the spontaneous brain activity and functional connections associated with somatic arousal. In this study, we investigated the relationship between state anxiety and the spontaneous brain activity of the somatosensory cortex in a non-clinical healthy population with state anxiety. Furthermore, we also explored the functional connections of the somatosensory cortex. We found that state anxiety was positively correlated with the amplitude of low-frequency fluctuations (ALFFs) of somatic related brain regions, including the right postcentral gyrus (somatosensory cortex) and the right precentral gyrus (somatic motor cortex). Furthermore, we found that state anxiety was positively correlated with the connections between the postcentral gyrus and the left cerebellum gyrus, whereas state anxiety was negatively correlated with the connectivity between the postcentral gyrus and brain regions including the left inferior frontal cortex and left medial superior frontal cortex. These results revealed the association between the anxious individuals' body-loop and state anxiety in a healthy population, which revealed the importance of somatic brain regions in anxiety symptoms and provided a new perspective on anxiety for further study.

The uncertain brain: A co-ordinate based meta-analysis of the neural signatures supporting uncertainty during different contexts

Uncertainty is often inevitable in everyday life and can be both stressful and exciting. Given its relevance to psychopathology and wellbeing, recent research has begun to address the brain basis of uncertainty. In the current review we examined whether there are discrete and shared neural signatures for different uncertain contexts. From the literature we identified three broad categories of uncertainty currently empirically studied using functional MRI (fMRI): basic threat and reward uncertainty, decision-making under uncertainty, and associative learning under uncertainty. We examined the neural basis of each category by using a coordinate based meta-analysis, where brain activation foci from previously published fMRI experiments were drawn together (1998-2017; 87 studies). The analyses revealed shared and discrete patterns of neural activation for uncertainty, such as the insula and amygdala, depending on the category. Such findings will have relevance for researchers attempting to conceptualise uncertainty, as well as clinical researchers examining the neural basis of uncertainty in relation to psychopathology.

What matters in "multimorbidity"? Arguably resilience and personal health experience are central to quality of life and optimizing survival

RATIONALE

Much is written about "multimorbidity" as it is a difficult problem for health systems, as it reflects a complex phenomenon unique to each individual health journey and health service context. This paper proposes the adoption of 2 constructs or knowledge streams into mainstream "multimorbidity" care which are arguably most important to person-centered care-personal health perceptions and resilience.

ANALYSIS

"Multimorbidity" is the manifestation of multiple nonlinear physical, psychosocial, and environmental phenomena in an individual health journey. Multimorbidity encompasses very stable states for the most part together with highly unstable phases that are difficult to manage. Averting or controlling the underlying loss of resilience in instability can be challenging without early warning signals pointing towards tipping points. Monitoring resilience and early warning signals for tipping points is new to health care. Yet what should we monitor in the complexity of multimorbidity? There are multiple and competing health service features and biometrics that can be measured. However, an expanding of literature endorses importance of simply asking a person about their self-rated health in order to provide predictions of their resilience and survival. Interoception, exemplified as self-rated health, arises from internal neurocognitive self-monitoring functions of different internal and external phenomena. Interoception is being to be recognized as predictors and barometers of resilience and survival.

CONCLUSIONS

Two phenomena of human systems-interoception and resilience-can guide care in the complex nature of multimorbidity in unstable health journeys and should be incorporated into clinical practice.

Virtually 'in the heat of the moment': insula activation in safe sex negotiation among risky men

HIV is most prevalent among men who have sex with men (MSM), and although most MSM use condoms consistently during casual sex, some take risks. To better understand the psychology of those risky decisions, we examined neural correlates of playing a virtual sexual 'hook up' game in an functional magnetic resonance imaging scanner in MSM who had, in the past 90 days, been sexually risky (N = 76) or safe (N = 31). We found that during potentially risky sexual choices, previously risky MSM had more right insula activity than previously safe MSM. Real-life sexual risk was related to trait positive and negative urgency. Insula activity that differentiated risky and safe MSM was related to trait positive and negative urgency. Future work should further examine if, and to what extent, insula activation during safe sex negotiation drives MSM's rash risky sexual decision-making.

Pain Perception and Body Awareness Among Individuals With Borderline Personality Disorder

Studies indicate that individuals with borderline personality disorder (BPD) often demonstrate attenuated pain perception, termed hypoalgesia. This study examines the hypothesis that body awareness moderates the association between BPD and pain perception. Participants consisted of 46 women diagnosed with BPD and 47 healthy controls. Sensory testing included the measurement of heat-pain thresholds, ratings of suprathreshold stimuli, measurement of temperature evoking moderate pain, and temporal summation of noxious mechanical stimuli. Body awareness was assessed by a self-report questionnaire. As hypothesized, among subjects with low levels of body awareness, those with BPD demonstrated hypoalgesia as manifested in their lower suprathreshold pain ratings and moderate pain evoked by higher temperature, in comparison with the controls. Among those with high levels of body awareness, BPD subjects demonstrated increased reactivity to pain as manifested in their higher pain ratings and moderate pain evoked by lower temperature, in comparison with the controls.

Endogenous GLP-1 alters postprandial functional connectivity between homeostatic and reward-related brain regions involved in regulation of appetite in healthy lean males: A pilotstudy

AIMS

Peripheral infusion of glucagon-like peptide-1 (GLP-1) can affect brain activity in areas involved in the regulation of appetite, including hypothalamic and reward-related brain regions. In contrast, the physiological role of endogenous GLP-1 in the central regulation of appetite has hardly been investigated.

MATERIALS AND METHODS

This was a randomized, cross-over trial that involved 12 healthy volunteers who received an intragastric (ig) glucose (gluc) load, with or without intravenous (iv) exendin9-39 (ex9-39; specific GLP-1 receptor antagonist). Functional magnetic resonance imaging was used to investigate the effect of endogenous GLP-1 on resting state functional connectivity (rsFC) between homeostatic and reward-related brain regions. Visual analogue scales were used to rate appetite-related sensations. Blood samples were collected for GI hormone measurements.

RESULTS

Administration of iv-ex9-39/ig-gluc induced a significantly higher rsFC, relative to ig-gluc administration, between the hypothalamus and the left lateral orbitofrontal cortex (OFC) as well as the left amygdala (P ≤ .001, respectively). Administration of iv-ex9-39/ig-gluc induced a significantly higher rsFC, relative to ig-gluc administration, between the right nucleus accumbens and the right lateral OFC (P < .001). Administration of iv-ex9-39/ig-gluc induced a significantly lower rsFC, relative to ig-gluc administration, between the midbrain and the right caudate nucleus (P = .001). Administration of ig-gluc significantly decreased prospective food consumption and increased sensations of fullness compared to pre-infusion baseline (P = .028 and P = .019, respectively); these effects were not present in the iv-ex9-39/ig-gluc condition.

CONCLUSIONS

This pilot trial provides preliminary experimental evidence that glucose-induced endogenous GLP-1 affects central regulation of appetite by modulating rsFC in homeostatic and reward-related brain regions in healthy lean male participants in a GLP-1 receptor-mediated fashion.

"I" and "Me": The Self in the Context of Consciousness

James (1890) distinguished two understandings of the self, the self as "Me" and the self as "I". This distinction has recently regained popularity in cognitive science, especially in the context of experimental studies on the underpinnings of the phenomenal self. The goal of this paper is to take a step back from cognitive science and attempt to precisely distinguish between "Me" and "I" in the context of consciousness. This distinction was originally based on the idea that the former ("Me") corresponds to the self as an object of experience (self as object), while the latter ("I") reflects the self as a subject of experience (self as subject). I will argue that in most of the cases (arguably all) this distinction maps onto the distinction between the phenomenal self (reflecting self-related content of consciousness) and the metaphysical self (representing the problem of subjectivity of all conscious experience), and as such these two issues should be investigated separately using fundamentally different methodologies. Moreover, by referring to Metzinger's (2018) theory of phenomenal self-models, I will argue that what is usually investigated as the phenomenal-"I" [following understanding of self-as-subject introduced by Wittgenstein (1958)] can be interpreted as object, rather than subject of experience, and as such can be understood as an element of the hierarchical structure of the phenomenal self-model. This understanding relates to recent predictive coding and free energy theories of the self and bodily self discussed in cognitive neuroscience and philosophy.

The Experience of Beauty of Chinese Poetry and Its Neural Substrates

Chinese poetry has a long history and high esthetic value. People who engage esthetically with Chinese poetry would feel the sense of beauty naturally. However, there is little information regarding what happens in the brain when an individual appreciates Chinese poetry, and how the brain processes the subject’s appreciation of beauty. Herein, we used functional magnetic resonance imaging (fMRI) to investigate the neural substrates of experiencing beauty by appreciating Chinese poetry. The participants in our study were 28 college students and the stimuli consisted of 25 Chinese poetry and 25 prose selections. Based on an event-related paradigm, the findings of this study suggested that different areas scattered in both the left and right cerebral hemispheres are activated when an individual appreciates Chinese poetry. Compared to reading prose, appreciating Chinese poetry heightens the activation of the left inferior orbitofrontal cortex (OFC), the bilateral insula, the left fusiform, the left supplementary motor area (SMA), and the left precentral gyrus. In these areas, the left inferior OFC and the bilateral insula are considered closely related to experiencing beauty of Chinese poetry, which have been demonstrated that it is an important neural basis of esthetic beauty when using other types of materials. The findings of this study shed new light on the complex but ordinary processes of experiencing beauty when appreciating Chinese poetry and show that some key processes underlying the feeling of esthetic beauty are shared across different esthetic domains.

Embodiment and Humiliation Moderation of Neural Responses to Others' Suffering in Female Submissive BDSM Practitioners

Giving and receiving pain are common in the practice of BDSM (bondage-discipline, dominance-submission, and sadism-masochism). Playing a submissive role during BDSM practice weakens both the behavioral and neural empathic responses of female individuals to others' suffering, suggesting that long-term BDSM experience affects BDSM practitioners' empathic ability. This study further investigates whether physical restriction during BDSM practice also modulates individuals' neural responses to others' suffering. We measured neural responses to others' suffering by recording event-related potentials (ERPs) in female submissives while they viewed painful and neutral expressions in sexual sadistic/general social contexts under ball gag Blocking and Relaxed conditions. The neural responses recorded during 92-112 ms (N1), 132-172 ms (P2), 200-340 ms (N2), early late positive potential (LPP, 400-600 ms), and late LPP (700-1,000 ms) were included in the analyses. Compared to the relaxed condition, when a ball gag was used to prevent facial muscle movement and facial mimicry, the N1, early LPP, and late LPP responses neural responses to others' suffering were inhibited. The moderation effect of ball gag blocking on the N1 and early LPP amplitudes was positively correlated with the subjective feelings of facial muscle stillness, and the blocking moderation effect on the late LPP amplitudes was positively correlated with subjective feelings of humiliation. This study is the first neuropsychological investigation of the transient BDSM-related physical restriction effects on BDSM practitioners. These findings suggest that physical restriction (via a ball gag) during BDSM practices increases the wearer's facial muscle stillness and sense of humiliation. This physical restriction inhibits both early automatic responses and late controlled processes in response to the suffering of others.

Emotions and the Right Hemisphere: Can New Data Clarify Old Models?

Models advanced to explain hemispheric asymmetries in representation of emotions will be discussed following their historical progression. First, the clinical observations that have suggested a general dominance of the right hemisphere for all kinds of emotions will be reviewed. Then the experimental investigations that have led to proposal of a different hemispheric specialization for positive versus negative emotions (valence hypothesis) or, alternatively, for approach versus avoidance tendencies (motivational hypothesis) will be surveyed. The discussion of these general models will be followed by a review of recent studies which have documented laterality effects within specific brain structures, known to play a critical role in different components of emotions, namely the amygdata in the computation of emotionally laden stimuli, the ventromedial prefrontal cortex in the integration between cognition and emotion and in the control of impulsive reactions and the anterior insula in the conscious experience of emotion. Results of these recent investigations support and provide an updated integrated version of early models assuming a general right hemisphere dominance for all kinds of emotions.