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Franco-O'Byrne D, Santamaría-García H, Migeot J, Ibáñez A. Emerging Theories of Allostatic-Interoceptive Overload in Neurodegeneration. Curr Top Behav Neurosci 2024. [PMID: 38637414 DOI: 10.1007/7854_2024_471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Recent integrative multilevel models offer novel insights into the etiology and course of neurodegenerative conditions. The predictive coding of allostatic-interoception theory posits that the brain adapts to environmental demands by modulating internal bodily signals through the allostatic-interoceptive system. Specifically, a domain-general allostatic-interoceptive network exerts adaptive physiological control by fine-tuning initial top-down predictions and bottom-up peripheral signaling. In this context, adequate adaptation implies the minimization of prediction errors thereby optimizing energy expenditure. Abnormalities in top-down interoceptive predictions or peripheral signaling can trigger allostatic overload states, ultimately leading to dysregulated interoceptive and bodily systems (endocrine, immunological, circulatory, etc.). In this context, environmental stress, social determinants of health, and harmful exposomes (i.e., the cumulative life-course exposition to different environmental stressors) may interact with physiological and genetic factors, dysregulating allostatic interoception and precipitating neurodegenerative processes. We review the allostatic-interoceptive overload framework across different neurodegenerative diseases, particularly in the behavioral variant frontotemporal dementia (bvFTD). We describe how concepts of allostasis and interoception could be integrated with principles of predictive coding to explain how the brain optimizes adaptive responses, while maintaining physiological stability through feedback loops with multiple organismic systems. Then, we introduce the model of allostatic-interoceptive overload of bvFTD and discuss its implications for the understanding of pathophysiological and neurocognitive abnormalities in multiple neurodegenerative conditions.
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Affiliation(s)
- Daniel Franco-O'Byrne
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Hernando Santamaría-García
- Global Brain Health Institute, University of California-San Francisco, San Francisco, CA, USA
- Trinity College Dublin, Dublin, Ireland
- Department of Psychiatry, Pontificia Universidad Javeriana, Bogotá, Colombia
- Center of Memory and Cognition Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Joaquín Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile.
- Global Brain Health Institute, University of California-San Francisco, San Francisco, CA, USA.
- Trinity College Dublin, Dublin, Ireland.
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina.
- Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland.
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Kj S, K MN, Shetty P. Integrated Yoga and Naturopathy Interventions to Modify Functional Disability in Patients With Spinal Cord Injury: A Randomized Controlled Trial. Cureus 2024; 16:e57686. [PMID: 38711714 PMCID: PMC11070886 DOI: 10.7759/cureus.57686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 05/08/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate the use of integrated yoga and naturopathy intervention to modify functional disability and improve independence in patients with spinal cord injury. MATERIALS AND METHODS In this randomized controlled trial, 48 spinal cord injury patients receiving residential rehabilitation, aged between 23 and 57 years (37.9±11.8) of both genders, were randomly allocated to two groups: (i) experimental group (naturopathy and yoga) and (ii) control group (waitlist with routine care). Subjects were assessed on day 1 (baseline), day 30 (intense phase), and day 90 (follow-up). Assessments were done using the Spinal Cord Independence Measure (SCIM), handheld myometry (HHM), time up and go (TUG), Berg Balance Scale (BBS), and 10-meter walk test (10MWT). RESULTS There were no significant differences at baseline between groups for all the variables (p>0.05) through one-way analysis of variance (ANOVA). Repeated measures ANOVAs (RM-ANOVAs) were performed to compare between assessments and the groups (p<0.05). Post hoc shows that there is significant SCIM (p<0.001), HHM (p<0.001), TUG (p<0.001), BBS (p<0.001), and 10MWT (p<0.001). CONCLUSION The present study shows that there is significant improvement in the functions of both yoga and naturopathy and the control group. So, yoga and naturopathy can be considered as adjuvant along with routine care of physical therapy in spinal cord injury rehabilitation programs.
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Affiliation(s)
- Sujatha Kj
- Natural Therapeutics, Sri Dharmasthala Manjunatheshwara (SDM) College of Naturopathy and Yogic Sciences, Mangalore, IND
| | - Manjunath N K
- Yoga, Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA), Bangalore, IND
| | - Prashanth Shetty
- Yoga, Sri Dharmasthala Manjunatheshwara (SDM) College of Naturopathy and Yogic Sciences, Mangalore, IND
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Schoeller F, Horowitz AH, Jain A, Maes P, Reggente N, Christov-Moore L, Pezzulo G, Barca L, Allen M, Salomon R, Miller M, Di Lernia D, Riva G, Tsakiris M, Chalah MA, Klein A, Zhang B, Garcia T, Pollack U, Trousselard M, Verdonk C, Dumas G, Adrien V, Friston K. Interoceptive technologies for psychiatric interventions: From diagnosis to clinical applications. Neurosci Biobehav Rev 2024; 156:105478. [PMID: 38007168 DOI: 10.1016/j.neubiorev.2023.105478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 11/16/2023] [Accepted: 11/19/2023] [Indexed: 11/27/2023]
Abstract
Interoception-the perception of internal bodily signals-has emerged as an area of interest due to its implications in emotion and the prevalence of dysfunctional interoceptive processes across psychopathological conditions. Despite the importance of interoception in cognitive neuroscience and psychiatry, its experimental manipulation remains technically challenging. This is due to the invasive nature of existing methods, the limitation of self-report and unimodal measures of interoception, and the absence of standardized approaches across disparate fields. This article integrates diverse research efforts from psychology, physiology, psychiatry, and engineering to address this oversight. Following a general introduction to the neurophysiology of interoception as hierarchical predictive processing, we review the existing paradigms for manipulating interoception (e.g., interoceptive modulation), their underlying mechanisms (e.g., interoceptive conditioning), and clinical applications (e.g., interoceptive exposure). We suggest a classification for interoceptive technologies and discuss their potential for diagnosing and treating mental health disorders. Despite promising results, considerable work is still needed to develop standardized, validated measures of interoceptive function across domains and before these technologies can translate safely and effectively to clinical settings.
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Affiliation(s)
- Felix Schoeller
- Fluid Interfaces Group, Media Lab, Massachusetts Institute of Technology, USA; Institute for Advanced Consciousness Studies, Santa Monica, CA, USA; Department Cognitive Sciences, University of Haifa, Israel.
| | - Adam Haar Horowitz
- Fluid Interfaces Group, Media Lab, Massachusetts Institute of Technology, USA; Center for Sleep and Cognition, Beth Israel Deaconess Medical Center, Harvard Medical School, USA
| | - Abhinandan Jain
- Fluid Interfaces Group, Media Lab, Massachusetts Institute of Technology, USA
| | - Pattie Maes
- Fluid Interfaces Group, Media Lab, Massachusetts Institute of Technology, USA
| | - Nicco Reggente
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | | | - Giovanni Pezzulo
- Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
| | - Laura Barca
- Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy
| | - Micah Allen
- Center of Functionally Integrative Neuroscience, Aarhus University, Denmark; Cambridge Psychiatry, University of Cambridge, UK
| | - Roy Salomon
- Department Cognitive Sciences, University of Haifa, Israel
| | - Mark Miller
- Center for Human Nature, Artificial Intelligence and Neuroscience, Hokkaido University, Japan
| | - Daniele Di Lernia
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy; Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy; Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Manos Tsakiris
- The Warburg Institute, School of Advanced Study, University of London, UK; Department of Psychology, Royal Holloway, University of London, UK; Department of Behavioural and Cognitive Sciences, University of Luxembourg, Luxembourg
| | - Moussa A Chalah
- EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est Créteil, Créteil, France; Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor, Créteil, France
| | - Arno Klein
- Child Mind Institute, New York City, USA
| | - Ben Zhang
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | - Teresa Garcia
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | - Ursula Pollack
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | - Marion Trousselard
- Institut de Recherche Biomédicale des Armées, Place Général Valérie André, 91220 Brétigny-sur-Orge, France
| | - Charles Verdonk
- Institut de Recherche Biomédicale des Armées, Place Général Valérie André, 91220 Brétigny-sur-Orge, France
| | | | - Vladimir Adrien
- Infrastructure for Clinical Research in Neurosciences (iCRIN) Psychiatry, Paris Brain Institute, Paris, France; Department of Psychiatry, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, 75012 Paris, France
| | - Karl Friston
- Queen Sq, Institute of Neurology, UCL, London WC1N 3AR, UK
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Renaghan E, Wittels HL, Feigenbaum LA, Wishon MJ, Chong S, Wittels ED, Hendricks S, Hecocks D, Bellamy K, Girardi J, Lee S, Vo T, McDonald SM, Wittels SH. Exposures to Elevated Core Temperatures during Football Training: The Impact on Autonomic Nervous System Recovery and Function. Sports (Basel) 2023; 12:8. [PMID: 38251282 PMCID: PMC10819443 DOI: 10.3390/sports12010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Exercising with elevated core temperatures may negatively affect autonomic nervous system (ANS) function. Additionally, longer training duration under higher core temperatures may augment these negative effects. This study evaluated the relationship between exercise training duration and 24 h ANS recovery and function at ≥37 °C, ≥38 °C and ≥39 °C core temperature thresholds in a sample of male Division I (D1) collegiate American football athletes. Fifty athletes were followed over their 25-week season. Using armband monitors (Warfighter MonitorTM, Tiger Tech Solutions, Inc., Miami, FL, USA), core temperature (°C) and 24 h post-exercise baseline heart rate (HR), HR recovery and heart rate variability (HRV) were measured. For HRV, two time-domain indices were measured: the root mean square of the standard deviation of the NN interval (rMSSD) and the standard deviation of the NN interval (SDNN). Linear regression models were performed to evaluate the associations between exercise training duration and ANS recovery (baseline HR and HRV) and function (HR recovery) at ≥37 °C, ≥38 °C and ≥39 °C core temperature thresholds. On average, the athletes were 21.3 (± 1.4) years old, weighed 103.0 (±20.2) kg and had a body fat percentage of 15.4% (±7.8%, 3.0% to 36.0%). The duration of training sessions was, on average, 161.1 (±40.6) min and they ranged from 90.1 to 339.6 min. Statistically significant associations between training duration and 24 h ANS recovery and function were observed at both the ≥38.0 °C (baseline HR: β = 0.10 ± 0.02, R2 = 0.26, p < 0.0000; HR recovery: β = -0.06 ± 0.02, R2 = 0.21, p = 0.0002; rMSSD: β = -0.11 ± 0.02, R2 = 0.24, p < 0.0000; and SDNN: β = -0.16 ± 0.04, R2 = 0.22, p < 0.0000) and ≥39.0 °C thresholds (β = 0.39 ± 0.05, R2 = 0.62, p < 0.0000; HR recovery: β = -0.26 ± 0.04, R2 = 0.52, p < 0.0000; rMSSD: β = -0.37 ± 0.05, R2 = 0.58, p < 0.0000; and SDNN: β = -0.67 ± 0.09, R2 = 0.59, p < 0.0000). With increasing core temperatures, increases in slope steepness and strengths of the associations were observed, indicating accelerated ANS deterioration. These findings demonstrate that exercise training under elevated core temperatures (≥38 °C) may negatively influence ANS recovery and function 24 h post exercise and progressively worsen.
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Affiliation(s)
- Eric Renaghan
- Department of Athletics, Sports Science, University of Miami, Miami, FL 33146, USA; (E.R.); (L.A.F.)
| | - Harrison L. Wittels
- Tiger Tech Solutions, Inc., Miami, FL 33156, USA; (H.L.W.); (M.J.W.); (S.C.); (E.D.W.); (S.H.); (D.H.); (S.H.W.)
| | - Luis A. Feigenbaum
- Department of Athletics, Sports Science, University of Miami, Miami, FL 33146, USA; (E.R.); (L.A.F.)
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, FL 33146, USA;
| | - Michael J. Wishon
- Tiger Tech Solutions, Inc., Miami, FL 33156, USA; (H.L.W.); (M.J.W.); (S.C.); (E.D.W.); (S.H.); (D.H.); (S.H.W.)
| | - Stephanie Chong
- Tiger Tech Solutions, Inc., Miami, FL 33156, USA; (H.L.W.); (M.J.W.); (S.C.); (E.D.W.); (S.H.); (D.H.); (S.H.W.)
| | - Eva D. Wittels
- Tiger Tech Solutions, Inc., Miami, FL 33156, USA; (H.L.W.); (M.J.W.); (S.C.); (E.D.W.); (S.H.); (D.H.); (S.H.W.)
| | - Stephanie Hendricks
- Tiger Tech Solutions, Inc., Miami, FL 33156, USA; (H.L.W.); (M.J.W.); (S.C.); (E.D.W.); (S.H.); (D.H.); (S.H.W.)
| | - Dustin Hecocks
- Tiger Tech Solutions, Inc., Miami, FL 33156, USA; (H.L.W.); (M.J.W.); (S.C.); (E.D.W.); (S.H.); (D.H.); (S.H.W.)
| | - Kyle Bellamy
- Department of Athletics, Nutrition, University of Miami, Miami, FL 33146, USA;
| | - Joe Girardi
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, FL 33146, USA;
| | - Stephen Lee
- United States Army Research Laboratory, Adelphi, MD 20783, USA;
| | - Tri Vo
- Navy Medical Center—San Diego, San Diego, CA 92134, USA;
| | - Samantha M. McDonald
- Tiger Tech Solutions, Inc., Miami, FL 33156, USA; (H.L.W.); (M.J.W.); (S.C.); (E.D.W.); (S.H.); (D.H.); (S.H.W.)
- School of Kinesiology and Recreation, Illinois State University, Normal, IL 61761, USA
| | - S. Howard Wittels
- Tiger Tech Solutions, Inc., Miami, FL 33156, USA; (H.L.W.); (M.J.W.); (S.C.); (E.D.W.); (S.H.); (D.H.); (S.H.W.)
- Department of Anesthesiology, Mount Sinai Medical Center, Miami, FL 33140, USA
- Department of Anesthesiology, Wertheim School of Medicine, Florida International University, Miami, FL 33199, USA
- Miami Beach Anesthesiology Associates, Miami, FL 33140, USA
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Kang H, Zsoldos RR, Sole-Guitart A, Narayan E, Cawdell-Smith AJ, Gaughan JB. Heat stress in horses: a literature review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:957-973. [PMID: 37060454 DOI: 10.1007/s00484-023-02467-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 06/15/2023]
Abstract
Healthy adult horses can balance accumulation and dissipation of body heat to maintain their body temperature between 37.5 and 38.5 °C, when they are in their thermoneutral zone (5 to 25 °C). However, under some circumstances, such as following strenuous exercise under hot, or hot and humid conditions, the accumulation of body heat exceeds dissipation and horses can suffer from heat stress. Prolonged or severe heat stress can lead to anhidrosis, heat stroke, or brain damage in the horse. To ameliorate the negative effects of high heat load in the body, early detection of heat stress and immediate human intervention is required to reduce the horse's elevated body temperature in a timely manner. Body temperature measurement and deviations from the normal range are used to detect heat stress. Rectal temperature is the most commonly used method to monitor body temperature in horses, but other body temperature monitoring technologies, percutaneous thermal sensing microchips or infrared thermometry, are currently being studied for routine monitoring of the body temperature of horses as a more practical alternative. When heat stress is detected, horses can be cooled down by cool water application, air movement over the horse (e.g., fans), or a combination of these. The early detection of heat stress and the use of the most effective cooling methods is important to improve the welfare of heat stressed horses.
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Affiliation(s)
- Hyungsuk Kang
- School of Agriculture and Food Sciences, The University of Queensland, Gatton, QLD, 4343, Australia.
| | - Rebeka R Zsoldos
- School of Agriculture and Food Sciences, The University of Queensland, Gatton, QLD, 4343, Australia
| | - Albert Sole-Guitart
- School of Veterinary Science, The University of Queensland, Gatton, QLD, 4343, Australia
| | - Edward Narayan
- School of Agriculture and Food Sciences, The University of Queensland, Gatton, QLD, 4343, Australia
| | - A Judith Cawdell-Smith
- School of Agriculture and Food Sciences, The University of Queensland, Gatton, QLD, 4343, Australia
| | - John B Gaughan
- School of Agriculture and Food Sciences, The University of Queensland, Gatton, QLD, 4343, Australia
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Interoceptive anxiety-related processes: Importance for understanding COVID-19 and future pandemic mental health and addictive behaviors and their comorbidity. Behav Res Ther 2022; 156:104141. [PMID: 35752013 PMCID: PMC9212258 DOI: 10.1016/j.brat.2022.104141] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 05/18/2022] [Accepted: 06/03/2022] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic is associated with an increased prevalence of mental health problems and addictive behaviors. There is a growing theoretical and empirical evidence that individual differences in interoceptive anxiety-related processes are a one set of vulnerability factors that are important in understanding the impact of pandemic-related mental health problems and addictive behavior. However, there has not been a comprehensive effort to explore this rapidly growing body of research and its implications for public health. In this paper, we discuss why interoceptive anxiety-related processes are relevant to understanding mental health and addictive behaviors during the COVID-19 pandemic. We then provide a narrative review of the available COVID-19 literature linking interoceptive fear and anxiety-related processes (e.g., anxiety sensitivity, health anxiety, and COVID-19 anxiety, fear, and worry) to mental health and addictive behaviors. We then propose a novel transdiagnostic theoretical model that highlights the role of interoceptive anxiety-related processes in mental health and addictive behavior in the context of the present and future pandemics. In the final section, we utilize this conceptualization to underscore clinical implications and provide guidance for future research initiatives in the management of COVID-19 mental health and addictive behaviors and inform the public health field for future pandemics.
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Radziun D, Crucianelli L, Ehrsson HH. Limits of Cross-modal Plasticity? Short-term Visual Deprivation Does Not Enhance Cardiac Interoception, Thermosensation, or Tactile Spatial Acuity. Biol Psychol 2021; 168:108248. [PMID: 34971758 DOI: 10.1016/j.biopsycho.2021.108248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 11/01/2021] [Accepted: 12/23/2021] [Indexed: 01/30/2023]
Abstract
In the present study, we investigated the effect of short-term visual deprivation on discriminative touch, cardiac interoception, and thermosensation by asking 64 healthy volunteers to perform four behavioral tasks. The experimental group contained 32 subjects who were blindfolded and kept in complete darkness for 110minutes, while the control group consisted of 32 volunteers who were not blindfolded but were otherwise kept under identical experimental conditions. Both groups performed the required tasks three times: before and directly after deprivation (or control) and after an additional washout period of 40minutes, in which all participants were exposed to normal light conditions. Our results showed that short-term visual deprivation had no effect on any of the senses tested. This finding suggests that short-term visual deprivation does not modulate basic bodily senses and extends this principle beyond tactile processing to the interoceptive modalities of cardiac and thermal sensations.
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Affiliation(s)
- Dominika Radziun
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Laura Crucianelli
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - H Henrik Ehrsson
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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Ebi KL, Capon A, Berry P, Broderick C, de Dear R, Havenith G, Honda Y, Kovats RS, Ma W, Malik A, Morris NB, Nybo L, Seneviratne SI, Vanos J, Jay O. Hot weather and heat extremes: health risks. Lancet 2021; 398:698-708. [PMID: 34419205 DOI: 10.1016/s0140-6736(21)01208-3] [Citation(s) in RCA: 339] [Impact Index Per Article: 113.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 12/15/2020] [Accepted: 05/20/2021] [Indexed: 01/18/2023]
Abstract
Hot ambient conditions and associated heat stress can increase mortality and morbidity, as well as increase adverse pregnancy outcomes and negatively affect mental health. High heat stress can also reduce physical work capacity and motor-cognitive performances, with consequences for productivity, and increase the risk of occupational health problems. Almost half of the global population and more than 1 billion workers are exposed to high heat episodes and about a third of all exposed workers have negative health effects. However, excess deaths and many heat-related health risks are preventable, with appropriate heat action plans involving behavioural strategies and biophysical solutions. Extreme heat events are becoming permanent features of summer seasons worldwide, causing many excess deaths. Heat-related morbidity and mortality are projected to increase further as climate change progresses, with greater risk associated with higher degrees of global warming. Particularly in tropical regions, increased warming might mean that physiological limits related to heat tolerance (survival) will be reached regularly and more often in coming decades. Climate change is interacting with other trends, such as population growth and ageing, urbanisation, and socioeconomic development, that can either exacerbate or ameliorate heat-related hazards. Urban temperatures are further enhanced by anthropogenic heat from vehicular transport and heat waste from buildings. Although there is some evidence of adaptation to increasing temperatures in high-income countries, projections of a hotter future suggest that without investment in research and risk management actions, heat-related morbidity and mortality are likely to increase.
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Affiliation(s)
- Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA.
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC, Australia; Sydney School of Public Health, Sydney, NSW, Australia
| | - Peter Berry
- Faculty of Environment, University of Waterloo, Waterloo, ON, Canada
| | - Carolyn Broderick
- School of Medical Sciences, UNSW Sydney, NSW, Australia; The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Richard de Dear
- Indoor Environmental Quality Laboratory, School of Architecture, Design, and Planning, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia
| | - George Havenith
- Environmental Ergonomics Research Centre, School of Design and Creative Arts, Loughborough University, Loughborough, UK
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - R Sari Kovats
- NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Wei Ma
- School of Public Health and Climate Change and Health Center, Shandong University, Jinan, China
| | - Arunima Malik
- Discipline of Accounting, Business School, Sydney, NSW, Australia; School of Physics, Faculty of Science, ISA, Sydney, NSW, Australia
| | - Nathan B Morris
- Thermal Ergonomics Laboratory, Sydney, NSW, Australia; Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lars Nybo
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Sonia I Seneviratne
- Institute for Atmospheric and Climate Science, ETH Zurich, Zurich, Switzerland
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, Tempe, AZ, USA
| | - Ollie Jay
- Thermal Ergonomics Laboratory, Sydney, NSW, Australia; Sydney School of Health Sciences, Sydney, NSW, Australia; Sydney School of Public Health, Sydney, NSW, Australia; Faculty of Medicine and Health, Charles Perkins Centre, Sydney, NSW, Australia
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9
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Fujimoto T, Fujii N, Dobashi K, Cao Y, Matsutake R, Takayanagi M, Kondo N, Nishiyasu T. Effects of low-intensity exercise on local skin and whole-body thermal sensation in hypothermic young males. Physiol Behav 2021; 240:113531. [PMID: 34280430 DOI: 10.1016/j.physbeh.2021.113531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/29/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
Thermal sensation, a key component of behavioral thermoregulation, is modulated by the changes in both skin and core temperatures. Although cutaneous thermal sensation to local cold is blunted during exercise as compared to rest in normothermic humans, it remains to be determined whether this holds true during core cooling. Furthermore, when local skin thermal sensation is diminished during exercise, it remains unclear whether whole-body thermal sensation is also attenuated. We therefore tested whether low-intensity exercise (VO2: ~1300 ml min-1) attenuates local skin and/or whole-body thermal sensation in hypothermic young males. Eleven healthy young males (24 ± 2 years) were cooled through cold water immersion (18 °C) up to their lower abdomen while resting (rest trial) and during low-intensity cycling (30-60 W, 30 rpm) (exercise trial). Body temperature, cardiorespiratory variables, and whole-body (9-point scale: 0, unbearably cold; 4, neutral; 8, unbearably hot) and local skin thermal sensation were measured at baseline on land and before the esophageal temperature (Tes) began to decrease (defined as -0.0 Tes) and after 0.5 and 1.0 °C decrements in Tes from baseline during the immersion period. Local skin thermal sensation was measured using a thermostimulator with Peltier element that was attached to the chest. The temperature of the probe was initially equilibrated to the chest skin temperature, then gradually decreased at a constant rate (0.1 °C s -1) until the participants felt coolness. The difference between the initial skin temperature and the local skin temperature that felt cool was assessed as an index of local skin thermal sensation. Throughout the immersions, esophageal and mean skin temperatures did not differ between the rest and exercise trials. Local skin thermal sensation also did not differ between the two trials or at any core temperature level. By contrast, the whole-body thermal sensation score was higher (participants felt less cold) in the exercise than in the rest trial at esophageal temperature of -1.0 °C (1.25 ± 0.46 vs. 0.63 ± 0.35 units, P = 0.035). These results suggest that local skin thermal sensation during low-intensity exercise is not affected by a decrease in core temperature. However, whole-body thermal sensation mediated by a decrease in core temperature (-1.0 °C) is blunted by low-intensity exercise during cold water immersion.
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Affiliation(s)
- Tomomi Fujimoto
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan; Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Naoto Fujii
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Kohei Dobashi
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Yinhang Cao
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan; School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
| | - Ryoko Matsutake
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | | | - Narihiko Kondo
- Laboratory for Applied Human Physiology, Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Takeshi Nishiyasu
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan.
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10
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Wecht JM, Krassioukov AV, Alexander M, Handrakis JP, McKenna SL, Kennelly M, Trbovich M, Biering-Sorensen F, Burns S, Elliott SL, Graves D, Hamer J, Krogh K, Linsenmeyer TA, Liu N, Hagen EM, Phillips AA, Previnaire JG, Rodriguez GM, Slocum C, Wilson JR. International Standards to document Autonomic Function following SCI (ISAFSCI): Second Edition. Top Spinal Cord Inj Rehabil 2021; 27:23-49. [PMID: 34108833 DOI: 10.46292/sci2702-23] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Jill M Wecht
- James J Peters VA Medical Center, Bronx, NY.,Bronx Veterans Medical Research Foundation, Bronx, NY.,Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.,Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries (ICORD) and Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia.,Spinal Cord Program, GF Strong Rehabilitation Centre, University of British Columbia, Vancouver, Canada.,GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada.,President, American Spinal Injury Association (ASIA)
| | - Maralee Alexander
- Sustain Our Abilities, Birmingham, AL.,University of Alabama at Birmingham School of Medicine, Birmingham, AL.,Spaulding Rehabilitation Hospital, Charlestown, MA
| | - John P Handrakis
- James J Peters VA Medical Center, Bronx, NY.,Bronx Veterans Medical Research Foundation, Bronx, NY.,New York Institute of Technology, Department of Physical Therapy, School of Health Professions, Old Westbury, NY
| | - Stephen L McKenna
- Department of Physical Medicine and Rehabilitation, Santa Clara Valley Medical Center, San Jose, CA.,Department of Neurosurgery, Stanford University, Stanford, CA
| | - Michael Kennelly
- James J Peters VA Medical Center, Bronx, NY.,Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY.,International Collaboration on Repair Discoveries (ICORD) and Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia
| | - Michele Trbovich
- South Texas Veterans Health Care System, San Antonio, TX.,Department of Rehabilitation Medicine, University of Texas Health San Antonio
| | - Fin Biering-Sorensen
- Department for Spinal Cord Injuries, Copenhagen University Hospital, Rigshospitalet, Denmark.,Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Stephen Burns
- Spinal Cord Injury Service, VA Puget Sound Health Care System, Seattle, WA.,Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
| | - Stacy L Elliott
- International Collaboration on Repair Discoveries (ICORD) and Division of Sexual Medicine, Departments of Psychiatry and Urologic Sciences, Faculty of Medicine, University of British Columbia
| | - Daniel Graves
- College of Rehabilitation Sciences, Department of Rehabilitation Medicine, Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, PA
| | | | - Klaus Krogh
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Todd A Linsenmeyer
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.,Department of Surgery ( Division of Urology), Rutgers New Jersey Medical School, Newark, NJ.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ
| | - Nan Liu
- Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing, China
| | - Ellen Merete Hagen
- National Hospital for Neurology and Neurosurgery, Queens Square, UCLH, London, UK.,Institute of Neurology, University College London, London, UK
| | - Aaron A Phillips
- Departments of Physiology and Pharmacology, Clinical Neurosciences, Cardiac Sciences, Hotchkiss Brain Institute, University of Calgary.,Cardiovascular Institute, Cumming School of Medicine, University of Calgary
| | | | - Gianna M Rodriguez
- Physical Medicine and Rehabilitation Department, Michigan Medicine, University of Michigan, Ann Arbor, MI
| | - Chloe Slocum
- Spaulding Rehabilitation Hospital, Charlestown, MA.,Harvard Medical School Department of Physical Medicine and Rehabilitation, Boston, MA
| | - James R Wilson
- Department of Physical Medicine and Rehabilitation, MetroHealth Rehabilitation Institute, Cleveland, OH.,Department of Physical Medicine and Rehabilitation, Case Western Reserve University-SOM, Cleveland, OH
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11
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Cheng Y, Jiao L, Li W, Wang J, Lin Z, Lai H, Ying B. Collagen type XVIII alpha 1 chain (COL18A1) variants affect the risk of anti-tuberculosis drug-induced hepatotoxicity: A prospective study. J Clin Lab Anal 2020; 35:e23630. [PMID: 33296124 PMCID: PMC7891502 DOI: 10.1002/jcla.23630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/16/2020] [Accepted: 09/24/2020] [Indexed: 02/05/2023] Open
Abstract
Background The role of collagen type XVIII alpha 1 chain (COL18A1) in anti‐tuberculosis drug‐induced hepatotoxicity (ATDH) has not been reported. This study aimed to explore the association between of COL18A1 variants and ATDH susceptibility. Methods A total of 746 patients were enrolled in our study from December 2016 to April 2018, and all subjects in the study signed an informed consent form. The custom‐by‐design 2x48‐Plex SNPscanTM kit was used to genotype all selected 11 SNPs. Categorical variables were compared by chi‐square (χ2) or Fisher's exact test, while continuous variables were compared by Mann‐Whitney's U test. Plink was utilized to analyze allelic and genotypic frequencies, and genetic models. Multivariate logistic regression analyses were used to adjust potential factors. The odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were also calculated. Results Among patients with successfully genotyping, there were 114 cases and 612 controls. The mutant A allele of rs12483377 conferred the decreased risk of ATDH (OR = 0.13, 95%CI: 0.02–0.98, P = 0.020), and this significance still existed after adjusting age and gender (P = 0.024). The mutant homozygote AA genotype of rs12483377 was associated with decreased total protein levels (P = 0.018). Conclusion Our study first revealed that the A allele of COL18A1 rs12483377 was associated with the decreased risk of ATDH in the Western Chinese Han population, providing new perspective for the molecular prediction, precise diagnosis, and individual treatment of ATDH.
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Affiliation(s)
- Yuhui Cheng
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Lin Jiao
- West China School of Medicine, Sichuan University, Chengdu, China.,Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Weixiu Li
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Jialing Wang
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Zhangyu Lin
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Hongli Lai
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Binwu Ying
- West China School of Medicine, Sichuan University, Chengdu, China.,Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
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12
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Thomas JK, Radic M, Tucker JR, Overbury R, Frech TM. Raynaud Phenomenon in Systemic Sclerosis: Does Digital Thermal Monitoring Correlate to Specific Nailfold Videocapillaroscopy Abnormalities? J Rheumatol 2020; 48:247-250. [PMID: 32541075 DOI: 10.3899/jrheum.191371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Early diagnosis of systemic sclerosis (SSc) is imperative, and Raynaud phenomenon (RP) is an important component of progressive vasculopathy. Nailfold videocapillaroscopy (NVC) is a well-established tool that can quantify structural vascular abnormalities. Digital thermal monitoring (DTM) assesses microvascular functional dysfunction related to thermoregulation. In this study, we investigated the correlation of NVC patterns and DTM variables in patients with SSc. METHODS Patients with SSc according to the 2013 American College of Rheumatology/European League Against Rheumatism criteria who consented and enrolled in the clinical care registry had NVC and DTM performed. For NVC, the number of capillaries (density), measurement of apical diameter (dimension), presence or absence of hemorrhages, and number of abnormal shapes were assessed to categorize 3 different qualitative patterns: early, active, and late. For DTM, Doppler ultrasound hyperemic, low frequency, blood velocity of radial artery, and fingertip vascular function were assessed, and a vascular reactivity index (VRI) measurement was automated. Statistical evaluation was performed by nonparametric tests to assess the correlation of NVC and VRI. RESULTS Thirty-one SSc subjects with interpretable NVC and DTM performed on the same day were included in the study. VRI was progressively higher in SSc patients with early, active, and late NVC patterns of microangiopathy (P < 0.0001). There was a significant negative correlation between VRI and microhemorrhages scores (r = -0.363, P = 0.044). CONCLUSION Our study suggests that more advanced vasculopathy correlates to reduced microvascular function as detected by DTM and more advanced structural abnormalities detected by NVC. NVC and DTM may provide different aspects of vasculopathy quantification and complement each other as investigative tools.
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Affiliation(s)
- Julie K Thomas
- J.K. Thomas, MD, University of Utah, Department of Internal Medicine, Division of Rheumatology, Salt Lake City, Utah, USA
| | - Mislav Radic
- M. Radic, MD, University of Utah, Department of Internal Medicine, Division of Rheumatology, Salt Lake City, Utah, USA, and University Hospital Split, Split, Croatia
| | - Jordan R Tucker
- J.R. Tucker, Salt Lake Veterans Affair Medical Center, Utah Vascular Research Laboratory, Salt Lake City, Utah, USA
| | - Rebecca Overbury
- R. Overbury, MD, University of Utah, Department of Internal Medicine, Division of Rheumatology, and University of Utah, Department of Pediatrics, Division of Rheumatology, Salt Lake City, Utah, USA
| | - Tracy M Frech
- T. Frech, MD, MS, University of Utah, Department of Internal Medicine, Division of Rheumatology, and Salt Lake Veterans Affair Medical Center, Utah Vascular Research Laboratory, Salt Lake City, Utah, USA.
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13
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Cowley KC. A new conceptual framework for the integrated neural control of locomotor and sympathetic function: implications for exercise after spinal cord injury. Appl Physiol Nutr Metab 2019; 43:1140-1150. [PMID: 30071179 DOI: 10.1139/apnm-2018-0310] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
All mammals, including humans, are designed to produce sustained locomotor movements. Many higher centres are involved in movement, but ultimately these centres act upon a core "rhythm-generating" network within the brainstem-spinal cord. In addition, endurance-based locomotor exercise requires sympathetic neural support to maintain homeostasis and to provide needed metabolic resources. This review focuses on the roles and integration of these 2 neural systems. Part I reviews the cardiovascular, thermoregulatory, and metabolic functions under spinal sympathetic control as revealed by spinal cord injury at different levels. Part II examines the integration between brainstem-spinal sympathetic pathways and the neural circuitry producing motor rhythms. In particular, the rostroventral medulla (RVM) contains the neural circuitry that (i) integrates heart rate, contractility, and blood flow in response to postural changes; (ii) initiates and maintains cardiovascular adaptations for exercise; (iii) provides direct descending innervation to preganglionic neurons innervating the adrenal glands, white adipose tissue, and tissues responsible for cooling the body; (iv) integrates descending sympathetic drive for energy substrate mobilization (lipolysis); and (v) is the relay for descending locomotor commands arising from higher brain centres. A unifying conceptual framework is presented, in which the RVM serves as the final descending supraspinal "exercise integration centre" linking the descending locomotor command signal with the metabolic and homeostatic support needed to produce prolonged rhythmic activities. The role and rationale for an ascending sympathetic and locomotor drive from the lower to upper limbs within this framework is presented. Examples of new research directions based on this unifying framework are discussed.
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Affiliation(s)
- Kristine C Cowley
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.,Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
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14
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Fealey RD. Thermoregulation in neuropathies. HANDBOOK OF CLINICAL NEUROLOGY 2018; 157:777-787. [PMID: 30459040 DOI: 10.1016/b978-0-444-64074-1.00048-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Peripheral neuropathy affecting autonomic and small sensory fibers can cause abnormalities of both autonomic and behavioral thermoregulation. Quantitative autonomic and sensory neurophysiologic tests and quantification of the linear density of intraepidermal nerve fibers potentially can stratify those at risk of impaired thermoregulation during cold and heat challenges. New data relating to thermoregulatory sweating impairment in neuropathy are presented in this chapter. Of 516 neuropathy patients analyzed, 345 were found to have thermoregulatory sweat test (TST) abnormalities with a mean percentage of anterior body surface anhidrosis (TST%) of 12% and a significant reduction in total body sweat rate, although the rate of core temperature rise with heating (slope) was not significantly different from that of patients with a normal TST. However a subset of abnormal TST patients having 25% or greater TST% showed a significantly more rapid rise in core temperature (lower slope) than age- and sex-matched neuropathy patients with a normal TST. Etiologies of neuropathy in this more severe group included diabetes, erythromelalgia, immune-mediated autonomic neuropathy, primary systemic amyloidosis, and neuropathy associated with postganglionic-autonomic degenerative disorders.
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Affiliation(s)
- Robert D Fealey
- Department of Neurology, Mayo Clinic, Rochester, MN, United States.
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15
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Khalsa SS, Adolphs R, Cameron OG, Critchley HD, Davenport PW, Feinstein JS, Feusner JD, Garfinkel SN, Lane RD, Mehling WE, Meuret AE, Nemeroff CB, Oppenheimer S, Petzschner FH, Pollatos O, Rhudy JL, Schramm LP, Simmons WK, Stein MB, Stephan KE, Van den Bergh O, Van Diest I, von Leupoldt A, Paulus MP. Interoception and Mental Health: A Roadmap. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:501-513. [PMID: 29884281 PMCID: PMC6054486 DOI: 10.1016/j.bpsc.2017.12.004] [Citation(s) in RCA: 405] [Impact Index Per Article: 67.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 11/20/2017] [Accepted: 12/10/2017] [Indexed: 12/29/2022]
Abstract
Interoception refers to the process by which the nervous system senses, interprets, and integrates signals originating from within the body, providing a moment-by-moment mapping of the body's internal landscape across conscious and unconscious levels. Interoceptive signaling has been considered a component process of reflexes, urges, feelings, drives, adaptive responses, and cognitive and emotional experiences, highlighting its contributions to the maintenance of homeostatic functioning, body regulation, and survival. Dysfunction of interoception is increasingly recognized as an important component of different mental health conditions, including anxiety disorders, mood disorders, eating disorders, addictive disorders, and somatic symptom disorders. However, a number of conceptual and methodological challenges have made it difficult for interoceptive constructs to be broadly applied in mental health research and treatment settings. In November 2016, the Laureate Institute for Brain Research organized the first Interoception Summit, a gathering of interoception experts from around the world, with the goal of accelerating progress in understanding the role of interoception in mental health. The discussions at the meeting were organized around four themes: interoceptive assessment, interoceptive integration, interoceptive psychopathology, and the generation of a roadmap that could serve as a guide for future endeavors. This review article presents an overview of the emerging consensus generated by the meeting.
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Affiliation(s)
- Sahib S Khalsa
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma.
| | - Ralph Adolphs
- California Institute of Technology, Pasadena, California
| | - Oliver G Cameron
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Hugo D Critchley
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
| | - Paul W Davenport
- Department of Physiology, University of Florida, Gainesville, Florida
| | - Justin S Feinstein
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma
| | - Jamie D Feusner
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Sarah N Garfinkel
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
| | - Richard D Lane
- Department of Psychiatry, University of Arizona, Tucson, Arizona
| | - Wolf E Mehling
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California
| | - Alicia E Meuret
- Department of Psychology, Southern Methodist University, Dallas, Texas
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, Florida
| | | | - Frederike H Petzschner
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland
| | - Olga Pollatos
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Jamie L Rhudy
- Department of Psychology, University of Tulsa, Tulsa, Oklahoma
| | - Lawrence P Schramm
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland; Department of Neuroscience, Johns Hopkins University, Baltimore, Maryland
| | - W Kyle Simmons
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma
| | - Murray B Stein
- Department of Psychiatry, University of California, San Diego, San Diego, California
| | - Klaas E Stephan
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland
| | | | - Ilse Van Diest
- Department of Health Psychology, University of Leuven, Leuven, Belgium
| | | | - Martin P Paulus
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma
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16
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Abstract
Heat exchange processes between the body and the environment are introduced. The definition of the thermoneutral zone as the ambient temperature range within which body temperature (Tb) regulation is achieved only by nonevaporative processes is explained. Thermoreceptors, thermoregulatory effectors (both physiologic and behavioral), and neural pathways and Tb signals that connect receptors and effectors into a thermoregulation system are reviewed. A classification of thermoeffectors is proposed. A consensus concept is presented, according to which the thermoregulation system is organized as a dynamic federation of independent thermoeffector loops. While the activity of each effector is driven by a unique combination of deep (core) and superficial (shell) Tbs, the regulated variable of the system can be viewed as a spatially distributed Tb with a heavily represented core and a lightly represented shell. Core Tb is the main feedback; it is always negative. Shell Tbs (mostly of the hairy skin) represent the auxiliary feedback, which can be negative or positive, and which decreases the system's response time and load error. Signals from the glabrous (nonhairy) skin about the temperature of objects in the environment serve as feedforward signals for various behaviors. Physiologic effectors do not use feedforward signals. The system interacts with other homeostatic systems by "meshing" with their loops. Coordination between different thermoeffectors is achieved through the common controlled variable, Tb. The term balance point (not set point) is used for a regulated level of Tb. The term interthreshold zone is used for a Tb range in which no effectors are activated. Thermoregulatory states are classified, based on whether: Tb is increased (hyperthermia) or decreased (hypothermia); the interthreshold zone is narrow (homeothermic type of regulation) or wide (poikilothermic type); and the balance point is increased (fever) or decreased (anapyrexia). During fever, thermoregulation can be either homeothermic or poikilothermic; anapyrexia is always a poikilothermic state. The biologic significance of poikilothermic states is discussed. As an example of practical applications of the concept presented, thermopharmacology is reviewed. Thermopharmacology uses drugs to modulate specific temperature signals at the level of a thermoreceptor (transient receptor potential channel).
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17
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Handrakis JP, Trbovich M, Hagen EM, Price M. Thermodysregulation in persons with spinal cord injury: case series on use of the autonomic standards. Spinal Cord Ser Cases 2017; 3:17086. [PMID: 29423292 PMCID: PMC5798926 DOI: 10.1038/s41394-017-0026-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 10/11/2017] [Accepted: 10/12/2017] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION The ability to maintain core body temperature (Tcore) within a narrow range (37 ± 0.6 °C), despite exposure to a wide range of ambient temperatures, is essential in order to provide an optimal environment for vital organs, the central nervous system (CNS), and cellular processes to function. High-level (above T6) spinal cord injury (SCI) interrupts the autonomic nervous system's ability to carry out hypothalamic regulation of thermoregulatory mechanisms for both heat dissipation and conservation. This interruption leaves persons with high-level SCI vulnerable to hyper and hypothermia even during exposure to relatively mild ambient temperatures. The goal of the Autonomic Standards is to enable the clinician to quickly identify those individuals with SCI who may be most at risk for thermoregulatory dysfunction. CASE PRESENTATION Case 1: Heat Exhaustion, Case 2: Heat Stroke in absence of CNS symptoms, Case 3: Heat Exhaustion. DISCUSSION The three cases demonstrate the signs and symptoms that may accompany hyperthermia in persons with SCI. The onset may be quite rapid and the condition persistent, despite ambient temperatures being much less intense than expected to be necessary to induce similar conditions in able-bodied (AB) persons. The responses of the persons in the case studies to the temperature regulation and autonomic control of sweating sections of the Autonomic Standards would identify them as being vulnerable and warrant providing appropriate exposure guidelines and precautions to them and their caregivers.
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Affiliation(s)
- John P. Handrakis
- VA RR&D National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, Bronx, NY USA
- New York Institute of Technology, Department of Physical Therapy, School of Health Professions, Old Westbury, NY USA
| | | | - Ellen Merete Hagen
- National Hospital for Neurology and Neurosurgery, Autonomic unit, London, UK
| | - Michael Price
- School of Life Sciences, Coventry University, Coventry, UK
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18
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Muzik O, Diwadkar VA. Regulation of Brown Adipose Tissue Activity by Interoceptive CNS Pathways: The interaction between Brain and Periphery. Front Neurosci 2017; 11:640. [PMID: 29200996 PMCID: PMC5696740 DOI: 10.3389/fnins.2017.00640] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 11/03/2017] [Indexed: 12/31/2022] Open
Abstract
To maintain thermal homeostasis, specific thermogenic tissues are under the control of central thermoregulatory networks that regulate the body's response to thermal challenges. One of these mechanisms involves non-shivering thermogenesis in brown adipose tissue (BAT), which is activated in cold environments in order to defend the body against physical damage as a result of hypothermia. The objective of our study was to assess the interaction between CNS thermoregulatory pathways and sympathetic innervation in BAT during a cold exposure paradigm. Our results show that an innocuous whole-body cooling paradigm induces significant differences in fMRI BOLD signal at the location of the right anterior insula and the red nucleus/substantia nigra region, between lean subjects with high levels of sympathetic innervation in supraclavicular BAT (BAT+ group), and subjects with low levels of sympathetic innervation (BAT− group). Specifically, results indicate significantly larger fMRI BOLD signal changes between periods of cooling and warming of the skin in the BAT+ (as compared to BAT−) group at the location of the right anterior insula. In contrast, the BAT+ group showed significantly smaller fMRI BOLD signal changes in the midbrain between periods of skin cooling and warming. Our findings are consistent with a hierarchical thermoregulatory control system that involves the initiation of inhibitory signals from the right anterior insula toward midbrain areas that normally exert tonic inhibition on the medullary raphe, from where BAT is directly innervated. Our data suggests that exposure to cold elicits differential neuronal activity in interoceptive regulatory centers of subjects with high and low level of sympathetic innervation. As a result, the variability of cold-activated BAT mass observed in humans might be, in part, yoked to different sensitivities of interoceptive cortical brain areas to skin temperature changes.
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Affiliation(s)
- Otto Muzik
- Departments of Pediatrics, Wayne State University School of Medicine, Detroit, MI, United States.,Radiology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Vaibhav A Diwadkar
- Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
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19
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Abstract
Water intake is one of the most basic physiological responses and is essential to sustain life. The perception of thirst has a critical role in controlling body fluid homeostasis and if neglected or dysregulated can lead to life-threatening pathologies. Clear evidence suggests that the perception of thirst occurs in higher-order centres, such as the anterior cingulate cortex (ACC) and insular cortex (IC), which receive information from midline thalamic relay nuclei. Multiple brain regions, notably circumventricular organs such as the organum vasculosum lamina terminalis (OVLT) and subfornical organ (SFO), monitor changes in blood osmolality, solute load and hormone circulation and are thought to orchestrate appropriate responses to maintain extracellular fluid near ideal set points by engaging the medial thalamic-ACC/IC network. Thirst has long been thought of as a negative homeostatic feedback response to increases in blood solute concentration or decreases in blood volume. However, emerging evidence suggests a clear role for thirst as a feedforward adaptive anticipatory response that precedes physiological challenges. These anticipatory responses are promoted by rises in core body temperature, food intake (prandial) and signals from the circadian clock. Feedforward signals are also important mediators of satiety, inhibiting thirst well before the physiological state is restored by fluid ingestion. In this Review, we discuss the importance of thirst for body fluid balance and outline our current understanding of the neural mechanisms that underlie the various types of homeostatic and anticipatory thirst.
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Affiliation(s)
- Claire Gizowski
- Centre for Research in Neuroscience, Research Institute of the McGill University Health Centre and Montreal General Hospital, 1650 Cedar Avenue, Montreal H3G1A4, Canada
| | - Charles W Bourque
- Centre for Research in Neuroscience, Research Institute of the McGill University Health Centre and Montreal General Hospital, 1650 Cedar Avenue, Montreal H3G1A4, Canada
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20
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Endocan concentrations in postmortem serum, vitreous humor and urine in victims of lethal hypothermia. J Forensic Leg Med 2017; 50:39-43. [DOI: 10.1016/j.jflm.2017.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/28/2017] [Accepted: 07/02/2017] [Indexed: 12/20/2022]
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21
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Descloux E, Ducrot K, Scarpelli MP, Lobrinus A, Palmiere C. Paradoxical undressing associated with subarachnoid hemorrhage in a non-hypothermia case? Int J Legal Med 2017; 131:1341-1345. [PMID: 28444440 DOI: 10.1007/s00414-017-1597-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/19/2017] [Indexed: 10/19/2022]
Abstract
Paradoxical undressing is a phenomenon characterizing some fatal hypothermia cases. The victims, despite low environmental temperatures, paradoxically remove their clothes due to a sudden feeling of warmth. In this report, we describe a case of suspected paradoxical undressing in a non-hypothermia case. The victim, a 51-year-old Caucasian man, was found dead wearing only sneakers and socks. All other clothing was found in his car. Postmortem investigations allowed the hypothesis of hypothermia to be ruled out and revealed the presence of a ruptured cerebral aneurysm that caused a subarachnoid hemorrhage, the latter responsible for the death. The absence of any elements suggesting a voluntary undressing or any third party's DNA profile or involvement along with the possibility that the subarachnoid hemorrhage might have determined a hypothalamic injury, somehow rendered conceivable the hypothesis of an inappropriate feeling of warmth due to hemorrhage-induced dysregulation of the hypothalamic temperature-regulating centers.
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Affiliation(s)
- Emilienne Descloux
- Centre Universitaire Romand de Médecine Légale, University Centre of Legal Medicine, Lausanne University Hospital, Chemin de la Vulliette 4, 1000, Lausanne, Switzerland
| | - Kewin Ducrot
- Centre Universitaire Romand de Médecine Légale, University Centre of Legal Medicine, Lausanne University Hospital, Chemin de la Vulliette 4, 1000, Lausanne, Switzerland
| | - Maria Pia Scarpelli
- Centre Universitaire Romand de Médecine Légale, University Centre of Legal Medicine, Lausanne University Hospital, Chemin de la Vulliette 4, 1000, Lausanne, Switzerland
| | - Alexander Lobrinus
- Division of Clinical Pathology, University Hospital Centre and University of Geneva, Geneva, Switzerland
| | - Cristian Palmiere
- Centre Universitaire Romand de Médecine Légale, University Centre of Legal Medicine, Lausanne University Hospital, Chemin de la Vulliette 4, 1000, Lausanne, Switzerland.
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Friston KJ. Self-evidencing babies: Commentary on “Mentalizing homeostasis: The social origins of interoceptive inference” by Fotopoulou & Tsakiris. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/15294145.2017.1295216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Core body temperature is normally tightly regulated to within a few tenths of a degree. The major thermoregulatory defences in humans are sweating, arteriovenous shunt vasoconstriction, and shivering. The core temperature triggering each response defines its activation threshold. General anaesthetics greatly impair thermoregulation, synchronously reducing the thresholds for vasoconstriction and shivering. Neuraxial anaesthesia also impairs central thermoregulatory control, and prevents vasoconstriction and shivering in blocked areas. Consequently, unwarmed anaesthetised patients become hypothermic, typically by 1-2°C. Hypothermia results initially from an internal redistribution of body heat from the core to the periphery, followed by heat loss exceeding metabolic heat production. Complications of perioperative hypothermia include coagulopathy and increased transfusion requirement, surgical site infection, delayed drug metabolism, prolonged recovery, shivering, and thermal discomfort. Body temperature can be reliably measured in the oesophagus, nasopharynx, mouth, and bladder. The standard-of-care is to monitor core temperature and to maintain normothermia during general and neuraxial anaesthesia.
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Affiliation(s)
- Daniel I Sessler
- Department of Outcomes Research, Cleveland Clinic, Cleveland, OH, USA.
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24
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Khalsa SS, Lapidus RC. Can Interoception Improve the Pragmatic Search for Biomarkers in Psychiatry? Front Psychiatry 2016; 7:121. [PMID: 27504098 PMCID: PMC4958623 DOI: 10.3389/fpsyt.2016.00121] [Citation(s) in RCA: 185] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 06/21/2016] [Indexed: 01/04/2023] Open
Abstract
Disrupted interoception is a prominent feature of the diagnostic classification of several psychiatric disorders. However, progress in understanding the interoceptive basis of these disorders has been incremental, and the application of interoception in clinical treatment is currently limited to panic disorder. To examine the degree to which the scientific community has recognized interoception as a construct of interest, we identified and individually screened all articles published in the English language on interoception and associated root terms in Pubmed, Psychinfo, and ISI Web of Knowledge. This search revealed that interoception is a multifaceted process that is being increasingly studied within the fields of psychiatry, psychology, neuroscience, and biomedical science. To illustrate the multifaceted nature of interoception, we provide a focused review of one of the most commonly studied interoceptive channels, the cardiovascular system, and give a detailed comparison of the most popular methods used to study cardiac interoception. We subsequently review evidence of interoceptive dysfunction in panic disorder, depression, somatic symptom disorders, anorexia nervosa, and bulimia nervosa. For each disorder, we suggest how interoceptive predictions constructed by the brain may erroneously bias individuals to express key symptoms and behaviors, and outline questions that are suitable for the development of neuroscience-based mental health interventions. We conclude that interoception represents a viable avenue for clinical and translational research in psychiatry, with a well-established conceptual framework, a neural basis, measurable biomarkers, interdisciplinary appeal, and transdiagnostic targets for understanding and improving mental health outcomes.
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Affiliation(s)
- Sahib S Khalsa
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA; Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, USA
| | - Rachel C Lapidus
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA; Department of Psychology, University of Tulsa, Tulsa, OK, USA
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Wecht JM, La Fountaine MF, Handrakis JP, West CR, Phillips A, Ditor DS, Sharif H, Bauman WA, Krassioukov AV. Autonomic Nervous System Dysfunction Following Spinal Cord Injury: Cardiovascular, Cerebrovascular, and Thermoregulatory Effects. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2015. [DOI: 10.1007/s40141-015-0093-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Shin KJ, Kim TH, Han YH, Mun CW, Kim SE, Ha SY, Park JS, Park KM. Cortical Morphology in Patients with Orthostatic Intolerance. Eur Neurol 2015; 73:264-70. [PMID: 25895544 DOI: 10.1159/000381540] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 03/08/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND We evaluated the cortical morphology in patients with orthostatic intolerance. METHODS Thirty patients with orthostatic intolerance, as well as age- and sex-matched normal controls, were enrolled in this study. We divided the patients into orthostatic hypotension (n = 22) and postural tachycardia syndrome (n = 8) groups based on their response to a head-up tilt table test. We analyzed whole-brain T1-weighted MRI images using FreeSurfer 5.1. The measures of cortical morphology were compared between the groups. RESULTS The cortical thickness in the right hemisphere, including the medial orbitofrontal, peri-calcarine, post-central, inferior temporal, and lateral occipital cortex, and in the peri-calcarine cortex of the left hemisphere was thinned in patients with orthostatic hypotension compared to normal controls. The other measures of cortical morphology, including the surface area, volume, and curvatures, did not differ between patients with orthostatic hypotension and normal controls. However, none of the measures of cortical morphology differed between patients with postural tachycardia syndrome and normal controls. CONCLUSIONS We demonstrated that the cortical morphology significantly changed in patients with orthostatic hypotension but not in patients with postural tachycardia syndrome compared to normal controls. These findings support the hypothesis that orthostatic intolerance is a heterogeneous syndrome.
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Affiliation(s)
- Kyong Jin Shin
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
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Abstract
The continuous rise in obesity is a major concern for future healthcare management. Many strategies to control body weight focus on a permanent modification of food intake with limited success in the long term. Metabolism or energy expenditure is the other side of the coin for the regulation of body weight, and strategies to enhance energy expenditure are a current focus for obesity treatment, especially since the (re)-discovery of the energy depleting brown adipose tissue in adult humans. Conversely, several human illnesses like neurodegenerative diseases, cancer, or autoimmune deficiency syndrome suffer from increased energy expenditure and severe weight loss. Thus, strategies to modulate energy expenditure to target weight gain or loss would improve life expectancies and quality of life in many human patients. The aim of this book chapter is to give an overview of our current understanding and recent progress in energy expenditure control with specific emphasis on central control mechanisms.
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Abstract
This review analyses whether skin temperature represents ambient temperature and serves as a feedforward signal for the thermoregulation system, or whether it is one of the body's temperatures and provides feedback. The body is covered mostly by hairy (non-glabrous) skin, which is typically insulated from the environment (with clothes in humans and with fur in non-human mammals). Thermal signals from hairy skin represent a temperature of the insulated superficial layer of the body and provide feedback to the thermoregulation system. It is explained that this feedback is auxiliary, both negative and positive, and that it reduces the system's response time and load error. Non-hairy (glabrous) skin covers specialized heat-exchange organs (e.g. the hand), which are also used to explore the environment. In thermoregulation, these organs are primarily effectors. Their main thermosensory-related role is to assess local temperatures of objects explored; these local temperatures are feedforward signals for various behaviours. Non-hairy skin also contributes to the feedback for thermoregulation, but this contribution is limited. Autonomic (physiological) thermoregulation does not use feedforward signals. Thermoregulatory behaviours use both feedback and feedforward signals. Implications of these principles to thermopharmacology, a new approach to achieving biological effects by blocking temperature signals with drugs, are discussed.
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Affiliation(s)
- A. A. Romanovsky
- Trauma Research Systemic Inflammation Laboratory (FeverLab) St. Joseph's Hospital and Medical Center Phoenix AZUSA
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