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Morrissey G, Tsuchiyagaito A, Takahashi T, McMillin J, Aupperle RL, Misaki M, Khalsa SS. Could neurofeedback improve therapist-patient communication? Considering the potential for neuroscience informed examinations of the psychotherapeutic relationship. Neurosci Biobehav Rev 2024; 161:105680. [PMID: 38641091 DOI: 10.1016/j.neubiorev.2024.105680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 03/22/2024] [Accepted: 04/16/2024] [Indexed: 04/21/2024]
Abstract
Empathic communication between a patient and therapist is an essential component of psychotherapy. However, finding objective neural markers of the quality of the psychotherapeutic relationship have been elusive. Here we conceptualize how a neuroscience-informed approach involving real-time neurofeedback, facilitated via existing functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) technologies, could provide objective information for facilitating therapeutic rapport. We propose several neurofeedback-assisted psychotherapy (NF-AP) approaches that could be studied as a way to optimize the experience of the individual patient and therapist across the spectrum of psychotherapeutic treatment. Finally, we consider how the possible strengths of these approaches are balanced by their current limitations and discuss the future prospects of NF-AP.
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Affiliation(s)
| | - Aki Tsuchiyagaito
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health and Natural Sciences, University of Tulsa, Tulsa, OK, USA
| | - Toru Takahashi
- Laureate Institute for Brain Research, Tulsa, OK, USA; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - John McMillin
- Advocate Medical Group, Downers Grove, IL, USA; Department of Psychiatry, University of Oklahoma-Tulsa, Tulsa, OK, USA
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health and Natural Sciences, University of Tulsa, Tulsa, OK, USA
| | - Masaya Misaki
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health and Natural Sciences, University of Tulsa, Tulsa, OK, USA
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health and Natural Sciences, University of Tulsa, Tulsa, OK, USA.
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2
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Barnes K, Wang R, Faasse K. Practitioner warmth and empathy attenuates the nocebo effect and enhances the placebo effect. Appl Psychol Health Well Being 2024; 16:421-441. [PMID: 37793644 DOI: 10.1111/aphw.12497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/21/2023] [Indexed: 10/06/2023]
Abstract
Augmented patient-practitioner interactions that enhance therapeutic alliance can increase the placebo effect to sham treatment. Little is known, however, about the effect of these interactions on maladaptive health outcomes (i.e., the nocebo effect). Healthy participants (N = 84) were randomised to a 3-day course of Oxytocin nasal drops (actually, sham treatment) in conjunction with a high-warmth interaction (Oxy-HW: N = 28), a low-warmth interaction (Oxy-LW: N = 28) or to a no treatment control group (NT: N = 28). All participants were informed that the Oxytocin treatment could increase psychological well-being but was associated with several potential side effects. Treatment-related side effects, unwarned symptoms, and psychological well-being were measured at baseline and all post-treatment days. Side effect reporting was increased in the Oxy-LW condition compared to the other groups across all days. Conversely, increased psychological well-being was observed in the Oxy-HW condition, relative to the other conditions, but only on Day 1. Among those receiving treatment, positive and negative expectations, and treatment-related worry, did not vary by interaction-style, while psychological well-being and side effect reporting were inversely associated at the level of the individual. Results have important implications for practice, suggesting poorer quality interactions may not only reduce beneficial health outcomes but also exacerbate those that are maladaptive.
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Affiliation(s)
- Kirsten Barnes
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Rachelle Wang
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Kate Faasse
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
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3
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Ibanez A, Kringelbach ML, Deco G. A synergetic turn in cognitive neuroscience of brain diseases. Trends Cogn Sci 2024; 28:319-338. [PMID: 38246816 DOI: 10.1016/j.tics.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/15/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024]
Abstract
Despite significant improvements in our understanding of brain diseases, many barriers remain. Cognitive neuroscience faces four major challenges: complex structure-function associations; disease phenotype heterogeneity; the lack of transdiagnostic models; and oversimplified cognitive approaches restricted to the laboratory. Here, we propose a synergetics framework that can help to perform the necessary dimensionality reduction of complex interactions between the brain, body, and environment. The key solutions include low-dimensional spatiotemporal hierarchies for brain-structure associations, whole-brain modeling to handle phenotype diversity, model integration of shared transdiagnostic pathophysiological pathways, and naturalistic frameworks balancing experimental control and ecological validity. Creating whole-brain models with reduced manifolds combined with ecological measures can improve our understanding of brain disease and help identify novel interventions. Synergetics provides an integrated framework for future progress in clinical and cognitive neuroscience, pushing the boundaries of brain health and disease toward more mature, naturalistic approaches.
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Affiliation(s)
- Agustin Ibanez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile; Global Brain Health Institute (GBHI), University California San Francisco (UCSF), San Francisco, CA, USA; Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; Department of Psychiatry, University of Oxford, Oxford, UK.
| | - Morten L Kringelbach
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Centre for Eudaimonia and Human Flourishing, University of Oxford, Oxford, UK
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Roc Boronat 138, Barcelona 08018, Spain; Institució Catalana de la Recerca i Estudis Avançats (ICREA), Passeig Lluís Companys 23, Barcelona 08010, Spain.
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4
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Boukarras S, Ferri D, Borgogni L, Aglioti SM. Neurophysiological markers of asymmetric emotional contagion: implications for organizational contexts. Front Integr Neurosci 2024; 18:1321130. [PMID: 38357225 PMCID: PMC10861795 DOI: 10.3389/fnint.2024.1321130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/02/2024] [Indexed: 02/16/2024] Open
Abstract
Emotions play a vital role within organizations, impacting various crucial aspects of work such as job satisfaction, performance, and employee well-being. Understanding how emotional states spread in organizational settings is therefore essential. Recent studies have highlighted that a leader's emotional state can influence their followers, with significant consequences on job performance. Leaders thus possess the ability to influence their employees' psychological state and, consequently, their well-being. However, the biological underpinnings of emotional contagion from leaders to followers remain unexplored. The field of interpersonal (neuro)physiology, which involves recording brain and peripheral activity of multiple individuals during interactions, holds great potential for investigating this phenomenon. Analyzing the time-lagged synchronization of neurophysiological activity during interactions may serve as a measure of the leader's influence on their followers in organizational contexts. In this "mini review," we examine empirical studies that have employed interpersonal (neuro)physiology to quantify the asymmetrical contagion of emotions in different contexts. Asymmetrical contagion was operationalized as the unidirectional influence exerted by one individual (i.e., the "sender") to another one (i.e., the "receiver"), whereby the receiver's state can be predicted by the sender's one. The reviewed literature reveals that delayed synchronization of physiological states is a widespread phenomenon that may underpin the transmission of emotions. These findings have significant implications for various aspects of organizational life, including leader-to-employee communication, and could drive the development of effective leadership training programs. We propose that Organizational Neuroscience may benefit from including interpersonal neurophysiology in its methodological toolkit for laboratory and field studies of leader-follower dynamics.
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Affiliation(s)
- Sarah Boukarras
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- Santa Lucia Foundation, IRCCS, Rome, Italy
| | - Donato Ferri
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- Ernst and Young (EY), Rome, Italy
| | - Laura Borgogni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Salvatore Maria Aglioti
- Santa Lucia Foundation, IRCCS, Rome, Italy
- Sapienza University of Rome and CLN2S@Sapienza, Italian Institute of Technology, Rome, Italy
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5
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Delgado MR, Fareri DS, Chang LJ. Characterizing the mechanisms of social connection. Neuron 2023; 111:3911-3925. [PMID: 37804834 PMCID: PMC10842352 DOI: 10.1016/j.neuron.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/07/2023] [Accepted: 09/08/2023] [Indexed: 10/09/2023]
Abstract
Understanding how individuals form and maintain strong social networks has emerged as a significant public health priority as a result of the increased focus on the epidemic of loneliness and the myriad protective benefits conferred by social connection. In this review, we highlight the psychological and neural mechanisms that enable us to connect with others, which in turn help buffer against the consequences of stress and isolation. Central to this process is the experience of rewards derived from positive social interactions, which encourage the sharing of perspectives and preferences that unite individuals. Sharing affective states with others helps us to align our understanding of the world with another's, thereby continuing to reinforce bonds and strengthen relationships. These psychological processes depend on neural systems supporting reward and social cognitive function. Lastly, we also consider limitations associated with pursuing healthy social connections and outline potential avenues of future research.
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Affiliation(s)
- Mauricio R Delgado
- Department of Psychology, Rutgers University-Newark, Newark, NJ 07102, USA.
| | - Dominic S Fareri
- Gordon F. Derner School of Psychology, Adelphi University, Garden City, NY 11530, USA
| | - Luke J Chang
- Consortium for Interacting Minds, Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH 03755, USA
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7
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Yoon DE, Lee S, Kim J, Kim K, Park HJ, Napadow V, Lee IS, Chae Y. Graded brain fMRI response to somatic and visual acupuncture stimulation. Cereb Cortex 2023; 33:11269-11278. [PMID: 37804240 DOI: 10.1093/cercor/bhad364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/09/2023] Open
Abstract
Increased stimulation can enhance acupuncture clinical response; however, the impact of acupuncture stimulation as "dosage" has rarely been studied. Furthermore, acupuncture can include both somatic and visual components. We assessed both somatic and visual acupuncture dosage effects on sensory ratings and brain response. Twenty-four healthy participants received somatic (needle inserted, manually stimulated) and visual (needle video, no manual stimulation) acupuncture over the leg at three different dosage levels (control, low-dose, and high-dose) during functional magnetic resonance imaging (fMRI). Participants reported the perceived deqi sensation for each acupuncture dose level. Blood-oxygen-level dependent imaging data were analyzed by general linear model and multivariate pattern analysis. For both somatic and visual acupuncture, reported deqi sensation increased with increased dosage of acupuncture stimulation. Brain fMRI analysis demonstrated that higher dosage of somatic acupuncture produced greater brain responses in sensorimotor processing areas, including anterior and posterior insula and secondary somatosensory cortex. For visual acupuncture, higher dosage of stimulation produced greater brain responses in visual-processing areas, including the middle temporal visual areas (V5/MT+) and occipital cortex. Psychophysical and psychophysiological responses to both somatic and visual acupuncture were graded in response to higher doses. Our findings suggest that acupuncture response may be enhanced by the dosage of needling-specific and nonspecific components, represented by different neural mechanisms.
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Affiliation(s)
- Da-Eun Yoon
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Seoyoung Lee
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jundong Kim
- Department of Ophthalmology, Otorhinolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
| | - Kyuseok Kim
- Department of Ophthalmology, Otorhinolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
| | - Hi-Joon Park
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
| | - Vitaly Napadow
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA 02129, United States
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA 02129, United States
| | - In-Seon Lee
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
| | - Younbyoung Chae
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul 02247, Korea
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA 02129, United States
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Olarewaju E, Dumas G, Palaniyappan L. Disorganized Communication and Social Dysfunction in Schizophrenia: Emerging Concepts and Methods. Curr Psychiatry Rep 2023; 25:671-681. [PMID: 37740852 DOI: 10.1007/s11920-023-01462-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE OF REVIEW In this review, we embrace the emerging field of second-person neuroscience to address disorganization in schizophrenia. We argue that the focus of interest for disorganization is the interpersonal space where shared mental processes ('social mind') occur based on the bio-behavioural synchrony between two (or more) interacting people. We lay out several bio-behavioural measures that can capture the component parts of this process. In particular, we highlight the real-time imaging technology of hyperscanning that enables multi-person analysis of naturalistic social interaction. We illustrate how these measures can be used in empirical studies by posing disorganization as a problem of interpersonal processing. RECENT FINDINGS Traditionally, disorganized speech and behaviour have been studied as the product of hidden cognitive processes ('private mind'). A dysfunction in these processes was attributed to the brain afflicted by the illness ('brain-bound mechanisms'). But this approach has contributed to challenges in measuring and quantifying disorganization. Consequently, the single-brain focus has not provided satisfactory clarity or led to effective treatments for persistent social dysfunction in schizophrenia. Social dysfunction is a core feature of schizophrenia. This dysfunction arises from disorganized interpersonal interaction that typifies the social profile of affected individuals. We outline challenges in employing several emerging concepts and methods and how they can be addressed to investigate the mechanisms of social dysfunction in schizophrenia.
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Affiliation(s)
- Emmanuel Olarewaju
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Guillaume Dumas
- Department of Psychiatry, CHU Sainte Justine Research Center, University of Montreal, Montreal, QC, Canada
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, QC, Canada
| | - Lena Palaniyappan
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
- Robarts Research Institute, Western University, London, ON, Canada.
- Department of Medical Biophysics, Western University, London, Canada.
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Ellingsen DM, Isenburg K, Jung C, Lee J, Gerber J, Mawla I, Sclocco R, Grahl A, Anzolin A, Edwards RR, Kelley JM, Kirsch I, Kaptchuk TJ, Napadow V. Brain-to-brain mechanisms underlying pain empathy and social modulation of pain in the patient-clinician interaction. Proc Natl Acad Sci U S A 2023; 120:e2212910120. [PMID: 37339198 PMCID: PMC10293846 DOI: 10.1073/pnas.2212910120] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/25/2023] [Indexed: 06/22/2023] Open
Abstract
Social interactions such as the patient-clinician encounter can influence pain, but the underlying dynamic interbrain processes are unclear. Here, we investigated the dynamic brain processes supporting social modulation of pain by assessing simultaneous brain activity (fMRI hyperscanning) from chronic pain patients and clinicians during video-based live interaction. Patients received painful and nonpainful pressure stimuli either with a supportive clinician present (Dyadic) or in isolation (Solo). In half of the dyads, clinicians performed a clinical consultation and intake with the patient prior to hyperscanning (Clinical Interaction), which increased self-reported therapeutic alliance. For the other half, patient-clinician hyperscanning was completed without prior clinical interaction (No Interaction). Patients reported lower pain intensity in the Dyadic, relative to the Solo, condition. In Clinical Interaction dyads relative to No Interaction, patients evaluated their clinicians as better able to understand their pain, and clinicians were more accurate when estimating patients' pain levels. In Clinical Interaction dyads, compared to No Interaction, patients showed stronger activation of the dorsolateral and ventrolateral prefrontal cortex (dlPFC and vlPFC) and primary (S1) and secondary (S2) somatosensory areas (Dyadic-Solo contrast), and clinicians showed increased dynamic dlPFC concordance with patients' S2 activity during pain. Furthermore, the strength of S2-dlPFC concordance was positively correlated with self-reported therapeutic alliance. These findings support that empathy and supportive care can reduce pain intensity and shed light on the brain processes underpinning social modulation of pain in patient-clinician interactions. Our findings further suggest that clinicians' dlPFC concordance with patients' somatosensory processing during pain can be boosted by increasing therapeutic alliance.
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Affiliation(s)
- Dan-Mikael Ellingsen
- Department of Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo0372, Norway
- Department of Psychology, Pedagogy and Law, School of Health Sciences, Kristiania University College, Oslo0107, Norway
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
| | - Kylie Isenburg
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
| | - Changjin Jung
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
- KM Research Science Division, Korea Institute of Oriental Medicine, Daejeon461-24, Republic of Korea
| | - Jeungchan Lee
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA02129
| | - Jessica Gerber
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
| | - Ishtiaq Mawla
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
| | - Roberta Sclocco
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Radiology, Logan University, Chesterfield, MO63017
| | - Arvina Grahl
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA02129
| | - Alessandra Anzolin
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA02129
| | - Robert R. Edwards
- Department of Anesthesiology, Brigham and Women’s Hospital, Boston, MA02115
| | - John M. Kelley
- School of Social Sciences, Communication, and Humanities, Endicott College, Beverley, MA02115
- Program in Placebo Studies & Therapeutic Encounter, Harvard Medical School, Boston, MA02215
| | - Irving Kirsch
- Program in Placebo Studies & Therapeutic Encounter, Harvard Medical School, Boston, MA02215
| | - Ted J. Kaptchuk
- Program in Placebo Studies & Therapeutic Encounter, Harvard Medical School, Boston, MA02215
| | - Vitaly Napadow
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Radiology, Logan University, Chesterfield, MO63017
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10
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Ryu J, Heisig S, McLaughlin C, Katz M, Mayberg HS, Gu X. A natural language processing approach reveals first-person pronoun usage and non-fluency as markers of therapeutic alliance in psychotherapy. iScience 2023; 26:106860. [PMID: 37255661 PMCID: PMC10225921 DOI: 10.1016/j.isci.2023.106860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 04/18/2023] [Accepted: 05/08/2023] [Indexed: 06/01/2023] Open
Abstract
It remains elusive what language markers derived from psychotherapy sessions are indicative of therapeutic alliance, limiting our capacity to assess and provide feedback on the trusting quality of the patient-clinician relationship. To address this critical knowledge gap, we leveraged feature extraction methods from natural language processing (NLP), a subfield of artificial intelligence, to quantify pronoun and non-fluency language markers that are relevant for communicative and emotional aspects of therapeutic relationships. From twenty-eight transcripts of non-manualized psychotherapy sessions recorded in outpatient clinics, we identified therapists' first-person pronoun usage frequency and patients' speech transition marking relaxed interaction style as potential metrics of alliance. Behavioral data from patients who played an economic game that measures social exchange (i.e. trust game) suggested that therapists' first-person pronoun usage may influence alliance ratings through their diminished trusting behavior toward therapists. Together, this work supports that communicative language features in patient-therapist dialogues could be markers of alliance.
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Affiliation(s)
- Jihan Ryu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephen Heisig
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Caroline McLaughlin
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Katz
- Clinical Psychology Doctoral Program, School of Health Professions and Nursing, Long Island University - CW Post Campus, Greenvale, NY, USA
| | - Helen S. Mayberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xiaosi Gu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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11
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Kaczmarska M. Valuing embodiment: insights from dance practice among people living with dementia. Front Neurol 2023; 14:1174157. [PMID: 37342779 PMCID: PMC10277497 DOI: 10.3389/fneur.2023.1174157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/08/2023] [Indexed: 06/23/2023] Open
Abstract
There is a growing appreciation for the ability of person-centered arts-based approaches to extend multiple domains of brain health of people living with dementia. Dance is a multi-modal artistic engagement which has positive impacts on cognition, mobility and the emotional and social aspects of brain health. Although research into multiple domains of brain health among older adults and people living with dementia is promising, several gaps remain, specifically in understanding the benefits of co-creative and improvisational dance practices. Collaborative research between dancers, researchers, people living with dementia and care partners is needed to design and evaluate future research on dance and to determine relevance and usability. Furthermore, the respective praxes and experience of researchers, dance artists and people living with dementia contribute distinctly and uniquely to the identification and the assignment of value to dance in the context of the lives of people living with dementia. In this manuscript the author, a community-based dance artist, creative aging advocate and Atlantic Fellow for Equity in Brain Health, discusses current challenges and gaps in the understanding of the value of dance for and with people living with dementia and how transdisciplinary collaboration between neuroscientists, dance artists and people living with dementia can advance collective comprehension and implementation of dance practice.
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Affiliation(s)
- Magda Kaczmarska
- Global Brain Health Institute, San Francisco, CA, United States
- Foundation Dementia Action Alliance Poland, Sopot, Poland
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12
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Jung C, Kim J, Choi S, Seo YK, Park KS, Choi Y, Choi SM, Kwon O, Song Y, Kim J, Cho G, Cheong C, Napadow V, Jung IC, Kim H. Attenuated facial movement in depressed women is associated with symptom severity, and nucleus accumbens functional connectivity. Neuroimage Clin 2023; 38:103380. [PMID: 36989853 PMCID: PMC10074984 DOI: 10.1016/j.nicl.2023.103380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
It is assumed that mood can be inferred from one's facial expression. While this association may prove to be an objective marker for mood disorders, few studies have explicitly evaluated this linkage. The facial movement responses of women with major depressive disorder (n = 66) and healthy controls (n = 46) under emotional stimuli were recorded using webcam. To boost facial movements, the naturalistic audio-visual stimuli were presented. To assess consistent global patterns across facial movements, scores for facial action units were extracted and projected onto principal component using principal component analysis. The associations of component for facial movements with functional brain circuitry was also investigated. Clusters of mouth movements, such as lip press and stretch, identified by principal component analysis, were attenuated in depressive patients compared to those in healthy controls. This component of facial movements was associated with depressive symptoms, and the strengths of resting brain functional connectivity between nucleus accumbens and both posterior insular cortex and thalamus. The evaluation of facial movements may prove to be a promising quantitative marker for assessing depressive symptoms and their underlying brain circuitry.
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Affiliation(s)
- Changjin Jung
- Division of KM Science Research, Korea Institute of Oriental Medicine, Daejeon, South Korea; Department of Electronics and Information Convergence Engineering, Kyung Hee University, Gyeonggi, South Korea
| | - Jieun Kim
- Division of KM Science Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Sunyoung Choi
- Division of KM Science Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Young Kyung Seo
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Ki-Sun Park
- Division of KM Science Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Youngeun Choi
- Division of KM Science Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Sung Min Choi
- Division of KM Science Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ojin Kwon
- Division of KM Science Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Youngkyu Song
- Bio-Chemical Analysis Team, Ochang Center, Korea Basic Science Institute, Chungbuk, South Korea
| | - Jooyeon Kim
- Bio-Chemical Analysis Team, Ochang Center, Korea Basic Science Institute, Chungbuk, South Korea
| | - Gyunggoo Cho
- Bio-Chemical Analysis Team, Ochang Center, Korea Basic Science Institute, Chungbuk, South Korea
| | - Chaejoon Cheong
- Bio-Chemical Analysis Team, Ochang Center, Korea Basic Science Institute, Chungbuk, South Korea
| | - Vitaly Napadow
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Network, Harvard Medical School, Charlestown, MA, USA
| | - In Chul Jung
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University, Daejeon, South Korea; Department of Neuropsychiatry, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, South Korea.
| | - Hyungjun Kim
- Division of KM Science Research, Korea Institute of Oriental Medicine, Daejeon, South Korea.
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13
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Kang H, Miksche MS, Ellingsen DM. Association between personality traits and placebo effects: a preregistered systematic review and meta-analysis. Pain 2023; 164:494-508. [PMID: 35947877 DOI: 10.1097/j.pain.0000000000002753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/02/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT Placebo effects are ubiquitous yet highly variable between individuals and therefore strongly affect clinical trial outcomes such as pain relief. It is unclear whether dispositional psychological traits influence responsiveness to placebo. This preregistered meta-analysis and systematic review synthesized the literature investigating the association between personality traits and placebo effects. Based on 21 studies with 798 participants, we performed formal meta-analyses for 10 different personality traits, including behavioral inhibition, fun seeking, goal-drive persistence, reward responsiveness, empathic concern, empathic fantasy, perspective-taking, personal distress, optimism, and anxiety. We did not find evidence of associations between any of these traits and magnitude of placebo effects, which was supported by equivalence tests. Furthermore, we did not find evidence for moderating factors such as placebo manipulation type (conditioning or nonconditioning) or condition (pain or nonpain). These findings challenge the notion that personality influences responsiveness to placebos and contradict its utility for identifying placebo "responders" and "nonresponders."
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Affiliation(s)
- Heemin Kang
- Department of Psychology, University of Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Dan-Mikael Ellingsen
- Department of Psychology, University of Oslo, Norway
- Division of Radiology and Nuclear Medicine, Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway
- School of Health Sciences, Kristiania University College, Oslo, Norway
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14
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Abstract
Studies of inter-brain relationships thrive, and yet many reservations regarding their scope and interpretation of these phenomena have been raised by the scientific community. It is thus essential to establish common ground on methodological and conceptual definitions related to this topic and to open debate about any remaining points of uncertainty. We here offer insights to improve the conceptual clarity and empirical standards offered by social neuroscience studies of inter-personal interaction using hyperscanning with a particular focus on verbal communication.
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Affiliation(s)
- Alejandro Pérez
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK.
| | - Matthew H Davis
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
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15
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Takeuchi N. Pain control based on oscillatory brain activity using transcranial alternating current stimulation: An integrative review. Front Hum Neurosci 2023; 17:941979. [PMID: 36742359 PMCID: PMC9892942 DOI: 10.3389/fnhum.2023.941979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 01/04/2023] [Indexed: 01/20/2023] Open
Abstract
Developing effective tools and strategies to relieve chronic pain is a high-priority scientific and clinical goal. In particular, the brain regions related to pain processing have been investigated as potential targets to relieve pain by non-invasive brain stimulation (NIBS). In addition to elucidating the relationship between pain and oscillatory brain activity, transcranial alternating current stimulation (tACS), which can non-invasively entrain oscillatory brain activity and modulate oscillatory brain communication, has attracted scientific attention as a possible technique to control pain. This review focuses on the use of tACS to relieve pain through the manipulation of oscillatory brain activity and its potential clinical applications. Several studies have reported that tACS on a single brain reduces pain by normalizing abnormal oscillatory brain activity in patients with chronic pain. Interpersonal tACS approaches based on inter-brain synchrony to manipulate inter-brain communication may result in pain relief via prosocial effects. Pain is encoded by the spatiotemporal neural communication that represents the integration of cognitive, emotional-affective, and sensorimotor aspects of pain. Therefore, future studies should seek to identify the pathological oscillatory brain communication in chronic pain as a therapeutic target for tACS. In conclusion, tACS could be effective for re-establishing oscillatory brain activity and assisting social interaction, and it might help develop novel approaches for pain control.
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16
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Wang LS, Cheng JT, Hsu IJ, Liou S, Kung CC, Chen DY, Weng MH. Distinct cerebral coherence in task-based fMRI hyperscanning: cooperation versus competition. Cereb Cortex 2022; 33:421-433. [PMID: 35266996 DOI: 10.1093/cercor/bhac075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 01/17/2023] Open
Abstract
This study features an functional magnetic resonance imaging (fMRI) hyperscanning experiment from 2 sites, 305 km apart. The experiment contains 2 conditions: the dyad collaborated to win and then split the reward in the cooperation condition, whereas the winner took all the reward in the competition condition, thereby resulting in dynamic strategic interactions. To calculate the cerebral coherence in such jittered event-related fMRI tasks, we first iteratively estimated the feedback-related blood oxygenation level-dependent responses of each trial, using 8 finite impulse response functions (16 s) and then concatenated the beta volume series. With the right temporal-parietal junction (rTPJ) as the seed, the interpersonal connected brain areas were separately identified: the right superior temporal gyrus (rSTG) (cooperation) and the left precuneus (lPrecuneus) (competition), both peaking at the designated frequency bin (1/16 s = 0.0625 Hz), but not in permuted pairs. In addition, the extended coherence analyses on shorter and longer concatenated volumes verified that only in the optimal trial frequency did the rTPJ-rSTG and rTPJ-lPrecuneus couplings peak. In sum, our approach both showcases a flexible analysis method that widens the applicability of interpersonal coherence in the rapid event-related fMRI hyperscanning and reveals a context-based inter-brain coupling between interacting pairs during cooperation and during competition.
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Affiliation(s)
- Le-Si Wang
- Institute of Creative Industries Design, National Cheng Kung University (NCKU), No. 1, University Road, Tainan City 701, Taiwan
| | - Jen-Tang Cheng
- Department of Economics, NCKU, No. 1, University Road, Tainan City 701, Taiwan
| | - I-Jeng Hsu
- Department of Economics, NCKU, No. 1, University Road, Tainan City 701, Taiwan
| | - Shyhnan Liou
- Institute of Creative Industries Design, National Cheng Kung University (NCKU), No. 1, University Road, Tainan City 701, Taiwan
| | - Chun-Chia Kung
- Department of Psychology, NCKU, No. 1, University Road, Tainan City 701, Taiwan.,Mind Research and Imaging (MRI) Center, No. 1, University Road, Tainan City 701, Taiwan
| | - Der-Yow Chen
- Department of Psychology, NCKU, No. 1, University Road, Tainan City 701, Taiwan.,Mind Research and Imaging (MRI) Center, No. 1, University Road, Tainan City 701, Taiwan
| | - Ming-Hung Weng
- Department of Economics, NCKU, No. 1, University Road, Tainan City 701, Taiwan
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17
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Viegas J, Holtby H, Runeckles K, Lang EV. The Impact of Scripted Self-Hypnotic Relaxation on the Periprocedural Experience and Anesthesiologist Sedation Use in the Pediatric Cardiac Catheterization Suite: A Prospective Randomized Controlled Trial. J Pain Res 2022; 15:3447-3458. [PMID: 36324867 PMCID: PMC9621219 DOI: 10.2147/jpr.s373608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose To assess the impact on children of self-hypnotic relaxation scripts read by trained staff prior to the induction of anesthesia and/or extubation on the periprocedural experience. Patients and Methods A total of 160 children aged 7–18 years undergoing a cardiac catheterization intervention under general anesthesia were randomized into 4 groups: (1) a pre-procedure (PP-script) read prior to entering the procedural room, (2) a script read prior to extubation (PX-Script), (3) both PP- and PX-Scripts read and (4) no script read. Anxiety and pain were rated on self-reported 0–10 scales. The modified Yale Preoperative Anxiety Scale was used for preoperative anxiety. The effect of script reading was associated with outcomes by linear regression for continuous variables, and logistic regression for binary variables in two-sided tests at a significance level of 0.05. Results are given in odds ratios (OR) and 95% confidence intervals (CI). Results Data were available for 158 patients. Reading the PP-Script prior to anesthesia was associated with a significant reduction in the use of intraoperative sedatives from 30% to 14% (OR 0.40; CI 0.18–0.88; p = 0.02) by the anesthesiologists, who were blinded to group attribution until extubation. This was despite the children not self-reporting significantly lower levels of anxiety or pain. The PX-Script did not change outcomes. Among groups, there was no significant difference in room time, postoperative recovery time and pain. Conclusion Reading a PP-Script for guidance in self-hypnotic relaxation can result in less need for intravenous sedation in the judgment of the anesthesiologist, independent of the children’s self-reported anxiety and pain. This raises interesting questions about subconscious patient–physician interactions affecting pain management. Clinicaltrials.gov Identifier NCT02347748.
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Affiliation(s)
- Jacqueline Viegas
- Cardiac Diagnostic and Interventional Unit, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada,Correspondence: Jacqueline Viegas, Cardiac Diagnostic and Interventional Unit, Labatt Family Heart Centre, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G1X8, Canada, Tel +1 416 659 4443, Fax +1 416 813 6404, Email
| | - Helen Holtby
- Department of Anesthesia, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kyle Runeckles
- University Health Network Research Institute, Toronto, Ontario, Canada
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18
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Chen L, Qu Y, Cao J, Liu T, Gong Y, Tian Z, Xiong J, Lin Z, Yang X, Yin T, Zeng F. The increased inter-brain neural synchronization in prefrontal cortex between simulated patient and acupuncturist during acupuncture stimulation: Evidence from functional near-infrared spectroscopy hyperscanning. Hum Brain Mapp 2022; 44:980-988. [PMID: 36255178 PMCID: PMC9875919 DOI: 10.1002/hbm.26120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/15/2022] [Accepted: 09/27/2022] [Indexed: 01/28/2023] Open
Abstract
The patient-acupuncturist interaction was a critical influencing factor for acupuncture effects but its mechanism remains unclear. This study aimed to examine the inter-brain mechanism of patient-acupuncturist dyad during acupuncture stimulation in a naturalistic clinical setting. Seventy healthy subjects (simulated "patients") were randomly assigned to two groups and received verum acupuncture group or sham acupuncture by one acupuncturist. Functional near-infrared spectroscopy hyperscanning was used to simultaneously record the neural responses of "patient"-acupuncturist dyad during acupuncture stimulation in each group. The results showed that inter-brain neural synchronization (INS) in the prefrontal cortex (PFC) of "patient"-acupuncturist dyad was significantly increased during verum but not sham acupuncture stimuli, and positively correlated with the needling sensations of "patients." Granger causality analysis demonstrated that there were no significant differences in INS direction between the "patient" and the acupuncturist. This study identified the increase of INS between "patient" and acupuncturist, and suggested that PFC was important to the interaction of "patient"-acupuncturist dyad.
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Affiliation(s)
- Li Chen
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina,Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Yuzhu Qu
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina,Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Jingya Cao
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina,Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Tianyu Liu
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina,Sport and Healthy SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Yulai Gong
- Department of NeurologySichuan Provincial Rehabilitation HospitalChengduSichuanChina
| | - Zilei Tian
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina,Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Jing Xiong
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China HospitalSichuan UniversityChengduSichuanChina
| | - Zhenfang Lin
- Department of NeurologySichuan Provincial Rehabilitation HospitalChengduSichuanChina
| | - Xin Yang
- Department of NeurologySichuan Provincial Rehabilitation HospitalChengduSichuanChina,Health and Rehabilitation SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Tao Yin
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina,Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Fang Zeng
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina,Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
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19
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Choi DH, Lee S, Lee IS, Chae Y. The role of visual expectations in acupuncture analgesia: A quantitative electroencephalography study. Mol Pain 2022; 18:17448069221128667. [PMID: 36196847 PMCID: PMC9537492 DOI: 10.1177/17448069221128667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Acupuncture is a complex treatment comprising multisensory stimulation, including visual and tactile sensations and experiences of body ownership. The purpose of this study was to investigate the role of these three components of acupuncture stimulation in acupuncture analgesia. 40 healthy volunteers participated in the study and received acupuncture treatment under three different conditions (real-hand, rubber-hand synchronous, and rubber-hand asynchronous). The tolerance for heat pain stimuli was measured before and after treatment. Brain oscillation changes were also measured using electroencephalography (EEG). The pain tolerance was significantly increased after acupuncture treatment under all three conditions. Noticeable deqi (needle) sensations in response to acupuncture stimulation of the rubber hand were found under both rubber-hand synchronous and rubber-hand asynchronous conditions. Deqi sensations were significantly correlated with acupuncture analgesia only under the rubber-hand synchronous condition. Increased delta and decreased theta, alpha, beta, and gamma waves were observed after acupuncture treatment under all three conditions. Our findings clarified the role of cognitive components of acupuncture treatment in acupuncture analgesia through the rubber-hand illusion. This study is a first step toward separating various components of acupuncture analgesia, i.e. visual, tactile, and body ownership, and utilizing those components to maximize analgesic effects.
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Affiliation(s)
| | | | - In-Seon Lee
- In-Seon Lee, Department of Science in
Korean Medicine, Graduate School, Kyung Hee University, 1 Hoegi-dong,
Dongdaemun-gu, Seoul 02447, Republic of Korea.
| | - Younbyoung Chae
- Younbyoung Chae, Department of Science in
Korean Medicine, Graduate School, Kyung Hee University, 1 Hoegi-dong,
Dongdaemun-gu, Seoul 02447, Republic of Korea.
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20
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Tsoi L, Burns SM, Falk EB, Tamir DI. The promises and pitfalls of functional magnetic resonance imaging hyperscanning for social interaction research. Soc Personal Psychol Compass 2022; 16:e12707. [PMID: 36407123 PMCID: PMC9667901 DOI: 10.1111/spc3.12707] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/23/2022] [Accepted: 08/26/2022] [Indexed: 11/28/2022]
Abstract
Social neuroscience combines tools and perspectives from social psychology and neuroscience to understand how people interact with their social world. Here we discuss a relatively new method-hyperscanning-to study real-time, interactive social interactions using functional magnetic resonance imaging (fMRI). We highlight three contributions that fMRI hyperscanning makes to the study of the social mind: (1) Naturalism: it shifts the focus from tightly-controlled stimuli to more naturalistic social interactions; (2) Multi-person Dynamics: it shifts the focus from individuals as the unit of analysis to dyads and groups; and (3) Neural Resolution: fMRI hyperscanning captures high-resolution neural patterns and dynamics across the whole brain, unlike other neuroimaging hyperscanning methods (e.g., electroencephalogram, functional near-infrared spectroscopy). Finally, we describe the practical considerations and challenges that fMRI hyperscanning researchers must navigate. We hope researchers will harness this powerful new paradigm to address pressing questions in today's society.
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Affiliation(s)
- Lily Tsoi
- School of Psychology and CounselingCaldwell UniversityCaldwellNew JerseyUSA
| | - Shannon M. Burns
- Department of Psychological SciencePomona CollegeClaremontCaliforniaUSA,Department of NeurosciencePomona CollegeClaremontCaliforniaUSA
| | - Emily B. Falk
- Annenberg School for CommunicationUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA,Department of PsychologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA,Wharton Marketing DepartmentUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA,Operations, Information, and Decisions DepartmentUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Diana I. Tamir
- Department of PsychologyPrinceton UniversityPrincetonNew JerseyUSA,Princeton Neuroscience InstitutePrinceton UniversityPrincetonNew JerseyUSA
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21
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Sharvit G, Schweinhardt P. The influence of social signals on the self-experience of pain: A neuroimaging review. Front Neurol 2022; 13:856874. [PMID: 36090868 PMCID: PMC9459049 DOI: 10.3389/fneur.2022.856874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Researchers in cognitive neuroscience have investigated extensively how psychological factors shape the processing and perception of pain using behavioral, physiological, and neuroimaging methods. However, social influences of pain, an essential part of biopsychosocial pain models, have received relatively little attention. This is particularly true for the neurobiological mechanisms underlying social modulations on pain. Therefore, this review discusses the findings of recent neuroimaging studies measuring the effects of social manipulations on pain perception (e.g., verbal and non-verbal social signals, social interaction style, conformity, social support, and sociocultural mediators). Finally, a schematic summary of the different social modulatory themes is presented.
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Affiliation(s)
- Gil Sharvit
- Department of Chiropractic Medicine, Integrative Spinal Research, Balgrist University Hospital, University of Zurich (UZH), Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich (UZH), Zurich, Switzerland
- *Correspondence: Gil Sharvit
| | - Petra Schweinhardt
- Department of Chiropractic Medicine, Integrative Spinal Research, Balgrist University Hospital, University of Zurich (UZH), Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich (UZH), Zurich, Switzerland
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22
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Zhou R, Zhu YJ, Chen X, Ma HC, Liu YH, Chang XS, Chen YD, Yu YY, Xiao ZZ, Liu LR, Li Y, Zhang HB. Effect of Sham Acupuncture on Chronic Pain: A Bayesian Network Meta-analysis. Pain Med 2022; 24:382-396. [PMID: 35993612 PMCID: PMC10069856 DOI: 10.1093/pm/pnac126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/18/2022] [Accepted: 08/11/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Along with increasing research on acupuncture for chronic pain, the validity of sham acupuncture (SA) has also been argued. METHODS Nine databases were searched for randomized controlled trials (RCTs) from the inception date to July 5, 2022. Using Markov Chain Monte Carlo methods, a Bayesian multiple treatment network meta-analysis (NMA) with random-effects model was conducted. RESULTS A total of 62 RCTs with 6806 patients and four kinds of treatments (real acupuncture (RA), non-acupuncture (NA), penetrative SA (PSA) and non-penetrative SA (NPSA)) were included. The results indicated that both NPSA and PSA were not superior to NA in improving chronic pain (NPSA: MD -4.77 [95% CI, -11.09 to 1.52]; PSA: MD, -4.96 [95% CI, -10.38 to 0.48]). After combining NPSA and PSA into the SA group, the weak trend of pain relief from SA was still not statistically significant (MD, -4.91 [95% CI, -9.93 to 0.05]). NPSA and PSA had similar effects (MD, 0.18 [95% CI, -5.45 to 5.81]). RA was significantly associated with pain relief, compared with NPSA and PSA (NPSA: MD, -12.03 [95% CI, -16.62 to -7.41]; PSA: MD, -11.85 [95% CI, -15.48 to -8.23]). The results were generally consistent regardless of pain phenotype, frequency, duration, acupuncture methods, analgesic intake, or detection bias. CONCLUSION These results suggested that acupuncture was significantly associated with reduced chronic pain. The two kinds of placebo acupuncture, NPSA and PSA, have similar effects. Both NPSA and PSA, with a weak but not significant effect, are appropriate to be inert placebo controls in RCTs for chronic pain.
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Affiliation(s)
- Rui Zhou
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yan-Juan Zhu
- Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Oncology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China.,Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, China
| | - Xian Chen
- Guangzhou University of Chinese Medicine, Guangzhou, China.,Department of Oncology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Hao-Chuan Ma
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi-Hong Liu
- Department of Oncology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Xue-Song Chang
- Department of Oncology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Ya-Dong Chen
- Department of Oncology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Ya-Ya Yu
- Department of Oncology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Zhen-Zhen Xiao
- Department of Oncology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Li-Rong Liu
- Department of Oncology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Yong Li
- Department of Oncology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Hai-Bo Zhang
- Department of Oncology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China.,Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou, China.,Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, China.,State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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23
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Graca S, Citkovitz C. From Bench to Bedside and Back Again: Developments in the Evidence-Informed Practice (and Practice-Informed Research) of Acupuncture. J Integr Complement Med 2022; 28:613-617. [PMID: 35862030 DOI: 10.1089/jicm.2022.0630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Sandro Graca
- Department of Research, Northern College of Acupuncture, York, United Kingdom
| | - Claudia Citkovitz
- Massachusetts College of Pharmacy and Health Sciences, New England College of Acupuncture, Worcester, MA, USA
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Tarbi EC, Blanch-Hartigan D, van Vliet LM, Gramling R, Tulsky JA, Sanders JJ. Toward a basic science of communication in serious illness. Patient Educ Couns 2022; 105:1963-1969. [PMID: 35410737 DOI: 10.1016/j.pec.2022.03.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 03/09/2022] [Accepted: 03/24/2022] [Indexed: 06/14/2023]
Abstract
High-quality communication can mitigate suffering during serious illness. Innovations in theory and technology present the opportunity to advance serious illness communication research, moving beyond inquiry that links broad communication constructs to health outcomes toward operationalizing and understanding the impact of discrete communication functions on human experience. Given the high stakes of communication during serious illness, we see a critical need to develop a basic science approach to serious illness communication research. Such an approach seeks to link "what actually happens during a conversation" - the lexical and non-lexical communication content elements, as well as contextual factors - with the emotional and cognitive experiences of patients, caregivers, and clinicians. This paper defines and justifies a basic science approach to serious illness communication research and outlines investigative and methodological opportunities in this area. A systematic understanding of the building blocks of serious illness communication can help identify evidence-informed communication strategies that promote positive patient outcomes, shape more targeted communication skills training for clinicians, and lead to more tailored and meaningful serious illness care.
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Affiliation(s)
- Elise C Tarbi
- Dana-Farber Cancer Institute, Department of Psychosocial Oncology and Palliative Care, Boston, USA.
| | | | | | - Robert Gramling
- University of Vermont. Department of Family Medicine, Burlington, USA.
| | - James A Tulsky
- Dana-Farber Cancer Institute, Department of Psychosocial Oncology and Palliative Care, Boston, USA; Brigham and Women's Hospital, Division of Palliative Medicine, Department of Medicine, Boston, USA.
| | - Justin J Sanders
- McGill University, Division of Palliative Care, Department of Family Medicine, Montreal, Canada.
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25
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Crum J, Zhang X, Noah A, Hamilton A, Tachtsidis I, Burgess PW, Hirsch J. An Approach to Neuroimaging Interpersonal Interactions in Mental Health Interventions. Biol Psychiatry Cogn Neurosci Neuroimaging 2022; 7:669-679. [PMID: 35144035 PMCID: PMC9271588 DOI: 10.1016/j.bpsc.2022.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/31/2021] [Accepted: 01/25/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Conventional paradigms in clinical neuroscience tend to be constrained in terms of ecological validity, raising several challenges to studying the mechanisms mediating treatments and outcomes in clinical settings. Addressing these issues requires real-world neuroimaging techniques that are capable of continuously collecting data during free-flowing interpersonal interactions and that allow for experimental designs that are representative of the clinical situations in which they occur. METHODS In this work, we developed a paradigm that fractionates the major components of human-to-human verbal interactions occurring in clinical situations and used functional near-infrared spectroscopy to assess the brain systems underlying clinician-client discourse (N = 30). RESULTS Cross-brain neural coupling between people was significantly greater during clinical interactions compared with everyday life verbal communication, particularly between the prefrontal cortex (e.g., inferior frontal gyrus) and inferior parietal lobule (e.g., supramarginal gyrus). The clinical tasks revealed extensive increases in activity across the prefrontal cortex, especially in the rostral prefrontal cortex (area 10), during periods in which participants were required to silently reason about the dysfunctional cognitions of the other person. CONCLUSIONS This work demonstrates a novel experimental approach to investigating the neural underpinnings of interpersonal interactions that typically occur in clinical settings, and its findings support the idea that particular prefrontal systems might be critical to cultivating mental health.
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Affiliation(s)
- James Crum
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
| | - Xian Zhang
- Brain Function Laboratory, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Adam Noah
- Brain Function Laboratory, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Antonia Hamilton
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Ilias Tachtsidis
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Paul W Burgess
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Joy Hirsch
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom; Brain Function Laboratory, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; Department of Neuroscience, Yale School of Medicine, New Haven, Connecticut; Department of Comparative Medicine, Yale School of Medicine, New Haven, Connecticut
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26
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McParlin Z, Cerritelli F, Rossettini G, Friston KJ, Esteves JE. Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Biobehavioural Synchrony in Musculoskeletal Care. Front Behav Neurosci 2022; 16:897247. [PMID: 35846789 PMCID: PMC9280207 DOI: 10.3389/fnbeh.2022.897247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/24/2022] [Indexed: 12/05/2022] Open
Abstract
Touch is recognised as crucial for survival, fostering cooperative communication, accelerating recovery, reducing hospital stays, and promoting overall wellness and the therapeutic alliance. In this hypothesis and theory paper, we present an entwined model that combines touch for alignment and active inference to explain how the brain develops "priors" necessary for the health care provider to engage with the patient effectively. We appeal to active inference to explain the empirically integrative neurophysiological and behavioural mechanisms that underwrite synchronous relationships through touch. Specifically, we offer a formal framework for understanding - and explaining - the role of therapeutic touch and hands-on care in developing a therapeutic alliance and synchrony between health care providers and their patients in musculoskeletal care. We first review the crucial importance of therapeutic touch and its clinical role in facilitating the formation of a solid therapeutic alliance and in regulating allostasis. We then consider how touch is used clinically - to promote cooperative communication, demonstrate empathy, overcome uncertainty, and infer the mental states of others - through the lens of active inference. We conclude that touch plays a crucial role in achieving successful clinical outcomes and adapting previous priors to create intertwined beliefs. The ensuing framework may help healthcare providers in the field of musculoskeletal care to use hands-on care to strengthen the therapeutic alliance, minimise prediction errors (a.k.a., free energy), and thereby promote recovery from physical and psychological impairments.
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Affiliation(s)
- Zoe McParlin
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | - Francesco Cerritelli
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | | | - Karl J. Friston
- Institute of Neurology, Wellcome Centre for Human Neuroimaging, London, United Kingdom
| | - Jorge E. Esteves
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
- Malta ICOM Educational, Gzira, Malta
- University College of Osteopathy, London, United Kingdom
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27
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Affiliation(s)
- Iñigo R Arandia
- Department of Philosophy, IAS-Research Center for Life, Mind and Society, University of the Basque Country, Donostia, Spain
- ISAAC Lab, Aragón Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain
| | - Ezequiel A Di Paolo
- Department of Philosophy, IAS-Research Center for Life, Mind and Society, University of the Basque Country, Donostia, Spain
- Ikerbasque, Basque Foundation for Science, Bizkaia, Spain
- Centre for Computational Neuroscience and Robotics, University of Sussex, Brighton, United Kingdom
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28
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McParlin Z, Cerritelli F, Friston KJ, Esteves JE. Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Synchrony. Front Psychol 2022; 13:783694. [PMID: 35250723 PMCID: PMC8892201 DOI: 10.3389/fpsyg.2022.783694] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 01/19/2022] [Indexed: 12/15/2022] Open
Abstract
Recognizing and aligning individuals' unique adaptive beliefs or "priors" through cooperative communication is critical to establishing a therapeutic relationship and alliance. Using active inference, we present an empirical integrative account of the biobehavioral mechanisms that underwrite therapeutic relationships. A significant mode of establishing cooperative alliances-and potential synchrony relationships-is through ostensive cues generated by repetitive coupling during dynamic touch. Established models speak to the unique role of affectionate touch in developing communication, interpersonal interactions, and a wide variety of therapeutic benefits for patients of all ages; both neurophysiologically and behaviorally. The purpose of this article is to argue for the importance of therapeutic touch in establishing a therapeutic alliance and, ultimately, synchrony between practitioner and patient. We briefly overview the importance and role of therapeutic alliance in prosocial and clinical interactions. We then discuss how cooperative communication and mental state alignment-in intentional communication-are accomplished using active inference. We argue that alignment through active inference facilitates synchrony and communication. The ensuing account is extended to include the role of (C-) tactile afferents in realizing the beneficial effect of therapeutic synchrony. We conclude by proposing a method for synchronizing the effects of touch using the concept of active inference.
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Affiliation(s)
- Zoe McParlin
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
| | - Francesco Cerritelli
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
| | - Karl J. Friston
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, London, United Kingdom
| | - Jorge E. Esteves
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
- Malta ICOM Educational Ltd., Gzira, Malta
- Research Department, University College of Osteopathy, London, United Kingdom
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29
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Affiliation(s)
| | - Luana Colloca
- School of Nursing & School of Medicine, University of Maryland, Baltimore, MD, USA
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30
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Lee S, Choi DH, Hong M, Lee IS, Chae Y. Open-Label Placebo Treatment for Experimental Pain: A Randomized-Controlled Trial with Placebo Acupuncture and Placebo Pills. J Integr Complement Med 2022; 28:136-145. [PMID: 35167363 DOI: 10.1089/jicm.2021.0177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: An open-label placebo (OLP) is a placebo treatment in which the patient is aware that the treatment is a placebo. OLPs are considered effective for reducing pain, and previous studies have shown a stronger placebo effect for placebo acupuncture than for placebo pills. In this study, the authors compared the analgesic effects of OLP pills, OLP acupuncture, and a no treatment condition in healthy participants, and then examined the factors contributing to the OLP effect. Design: Randomized controlled crossover trial. Settings/Location: College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea. Subjects: 34 healthy participants. Intervention: Participants received three different treatments ("OLP-pill," "OLP-acupuncture," and "no treatment") on three separate days in random order. Outcome Measurements: Before and after the treatment, heat pain stimuli were applied to the participants' hands, and pain tolerance, intensity, and unpleasantness were measured using a visual analog scale (range, 0-10). Results: Data of 31 participants were included in the analysis. The authors found significant analgesic effects of the placebo pill and placebo acupuncture in the OLP condition. Regression analyses revealed that expectations regarding treatment and practitioner identity influenced the analgesic effects of OLP acupuncture. There was no adverse event. Conclusions: Expectations regarding treatment and practitioner identity influenced the analgesic effect of placebo acupuncture without deception. These findings provide new information regarding the cognitive factors underlying pharmacologic and nonpharmacologic treatments. Clinical Trial Registration Number: KCT0004928.
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Affiliation(s)
- Seoyoung Lee
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Dha-Hyun Choi
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Minyoung Hong
- Acupuncture and Meridian Science Research Center, Kyung Hee University, Seoul, Republic of Korea
| | - In-Seon Lee
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea.,Acupuncture and Meridian Science Research Center, Kyung Hee University, Seoul, Republic of Korea
| | - Younbyoung Chae
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea.,Acupuncture and Meridian Science Research Center, Kyung Hee University, Seoul, Republic of Korea
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31
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Ellingsen DM, Duggento A, Isenburg K, Jung C, Lee J, Gerber J, Mawla I, Sclocco R, Edwards RR, Kelley JM, Kirsch I, Kaptchuk TJ, Toschi N, Napadow V. Patient-clinician brain concordance underlies causal dynamics in nonverbal communication and negative affective expressivity. Transl Psychiatry 2022; 12:44. [PMID: 35091536 DOI: 10.1038/s41398-022-01810-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/03/2022] [Accepted: 01/12/2022] [Indexed: 12/13/2022] Open
Abstract
Patient-clinician concordance in behavior and brain activity has been proposed as a potential key mediator of mutual empathy and clinical rapport in the therapeutic encounter. However, the specific elements of patient-clinician communication that may support brain-to-brain concordance and therapeutic alliance are unknown. Here, we investigated how pain-related, directional facial communication between patients and clinicians is associated with brain-to-brain concordance. Patient-clinician dyads interacted in a pain-treatment context, during synchronous assessment of brain activity (fMRI hyperscanning) and online video transfer, enabling face-to-face social interaction. In-scanner videos were used for automated individual facial action unit (AU) time-series extraction. First, an interpretable machine-learning classifier of patients' facial expressions, from an independent fMRI experiment, significantly distinguished moderately painful leg pressure from innocuous pressure stimuli. Next, we estimated neural-network causality of patient-to-clinician directional information flow of facial expressions during clinician-initiated treatment of patients' evoked pain. We identified a leader-follower relationship in which patients predominantly led the facial communication while clinicians responded to patients' expressions. Finally, analyses of dynamic brain-to-brain concordance showed that patients' mid/posterior insular concordance with the clinicians' anterior insula cortex, a region identified in previously published data from this study1, was associated with therapeutic alliance, and self-reported and objective (patient-to-clinician-directed causal influence) markers of negative-affect expressivity. These results suggest a role of patient-clinician concordance of the insula, a social-mirroring and salience-processing brain node, in mediating directional dynamics of pain-directed facial communication during therapeutic encounters.
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32
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Dikker S, Mech EN, Gwilliams L, West T, Dumas G, Federmeier KD. Exploring age-related changes in inter-brain synchrony during verbal communication. Psychology of Learning and Motivation 2022. [DOI: 10.1016/bs.plm.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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33
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Cheng X, Zhu Y, Hu Y, Zhou X, Pan Y, Hu Y. Integration of social status and trust through interpersonal brain synchronization. Neuroimage 2021; 246:118777. [PMID: 34864151 DOI: 10.1016/j.neuroimage.2021.118777] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 11/20/2022] Open
Abstract
Trust can be a dynamic social process, during which the social identity of the interacting agents (e.g., an investor and a trustee) can bias trust outcomes. Here, we investigated how social status modulates trust and the neural mechanisms underlying this process. An investor and a trustee performed a 10-round repeated trust game while their brain activity was being simultaneously recorded using functional near-infrared spectroscopy. The social status (either high or low) of both investors and trustees was manipulated via a math competition task. The behavioral results showed that in the initial round, individuals invested more in low-status partners. However, the investment ratio increased faster as the number of rounds increased during trust interaction when individuals were paired with a high-status partner. This increasing trend was particularly prominent in the low (investor)-high (trustee) status group. Moreover, the low-high group showed increased investor-trustee brain synchronization in the right temporoparietal junction as the number of rounds increased, while brain activation in the right dorsolateral prefrontal cortex of the investor decreased as the number of rounds increased. Both interpersonal brain synchronization and brain activation predicted investment performance at the early stage; furthermore, two-brain data provided earlier predictions than did single-brain data. These effects were detectable in the investment phase in the low-high group only; no comparable effects were observed in the repayment phase or other groups. Overall, this study demonstrated a multi-brain mechanism for the integration of social status and trust.
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34
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Abstract
Pain is a fundamental experience that promotes survival. In humans, pain stands at the intersection of multiple health crises: chronic pain, the opioid epidemic, and health disparities. The study of placebo analgesia highlights how social, cognitive, and affective processes can directly shape pain, and identifies potential paths for mitigating these crises. This review examines recent progress in the study of placebo analgesia through affective science. It focuses on how placebo effects are shaped by expectations, affect, and the social context surrounding treatment, and discusses neurobiological mechanisms of placebo, highlighting unanswered questions and implications for health. Collaborations between clinicians and social and affective scientists can address outstanding questions and leverage placebo to reduce pain and improve human health.
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Affiliation(s)
- Lauren Y Atlas
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA; National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA; National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA.
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35
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Peter B, Wolf TG. Replication Studies on Significant Differences in Personality Profiles of Securely and Insecurely Attached Psychotherapists and Dentists. Front Psychol 2021; 12:662828. [PMID: 34658991 PMCID: PMC8517179 DOI: 10.3389/fpsyg.2021.662828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
This study contributes to the therapist variable in general and the personality profile of securely and insecurely attached psychotherapists and other healthcare professionals in particular. In a preceding study, it has been found that insecurely attached psychotherapists differ in nine personality styles from securely attached ones. The aim of the present study was to replicate these findings and to investigate whether they also apply to other health professions such as dentists. About 891 subjects from two German professional societies for hypnosis were surveyed online with a personality questionnaire [Personality Styles and Disorder Inventory (PSDI)] and an attachment questionnaire [Relationship Scale Questionnaire (RSQ)]. Since these subjects were interested in hypnosis and used it in their practice (HYP), 150 dentists without a hypnosis context (NONHYP) were studied as a control group with the same survey. The results of the preceding attachment study could be replicated: Insecurely attached healthcare professionals differed significantly from securely attached ones in the same nine (plus one, i.e., 10) personality styles if they use psychological methods including hypnosis. If they do not use psychological methods (like the NONHYP dentists), they differ in half of the personality styles. No within-sample and no between-sample differences have been found in the assertive/antisocial (AS) personality style. No within-sample differences have also been found in the conscientious/compulsive (ZW) and the intuitive/schizotypal (ST) personality styles. However, large between-sample differences were obvious in ZW and the ST. Both of the samples of the dentist were much more compulsive than the two psychotherapeutic samples. In addition, both of the HYP samples were much more schizotypal than the NONHYP samples. The latter is the general signature of those individuals who are interested in hypnosis and were metaphorically termed homo hypnoticus. It seems that AS, ZW, and ST are independent of attachment.
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Affiliation(s)
- Burkhard Peter
- MEG-Stiftung München, Munich, Germany
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Thomas G. Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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36
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Chen PHA, Qu Y. Taking a Computational Cultural Neuroscience Approach to Study Parent-Child Similarities in Diverse Cultural Contexts. Front Hum Neurosci 2021; 15:703999. [PMID: 34512293 PMCID: PMC8426574 DOI: 10.3389/fnhum.2021.703999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/19/2021] [Indexed: 12/03/2022] Open
Abstract
Parent-child similarities and discrepancies at multiple levels provide a window to understand the cultural transmission process. Although prior research has examined parent-child similarities at the belief, behavioral, and physiological levels across cultures, little is known about parent-child similarities at the neural level. The current review introduces an interdisciplinary computational cultural neuroscience approach, which utilizes computational methods to understand neural and psychological processes being involved during parent-child interactions at intra- and inter-personal level. This review provides three examples, including the application of intersubject representational similarity analysis to analyze naturalistic neuroimaging data, the usage of computer vision to capture non-verbal social signals during parent-child interactions, and unraveling the psychological complexities involved during real-time parent-child interactions based on their simultaneous recorded brain response patterns. We hope that this computational cultural neuroscience approach can provide researchers an alternative way to examine parent-child similarities and discrepancies across different cultural contexts and gain a better understanding of cultural transmission processes.
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Affiliation(s)
- Pin-Hao A. Chen
- Department of Psychology, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
- Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, Taiwan
| | - Yang Qu
- School of Education and Social Policy, Northwestern University, Evanston, IL, United States
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37
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Affiliation(s)
- Seth S Leopold
- Editor-In-Chief, Clinical Orthopaedics and Related Research® , Philadelphia, PA, USA
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Abstract
Based on vignettes from clinical cases, supervision and Balint groups this article presents a neo-phenomenological perspective on the lived experience of healthcare professionals in interactions with patients and relatives. Specifically, the familiar phenomenon of "something in the air" between two persons will be analyzed.Constellations and situations are presented as fundamental and generic (ontological) categories that can be differentiated to understand the details and the whole (die Gestalt) of an interaction.The term atmosphere is introduced to investigate the material carrier of something that "colors the air" between healthcare provider and patient.The neo-phenomenological taxonomy of the lived body (der Leib) is used to describe the recipient structure of atmospheric mood.Finally, the potential of these concepts for a more comprehensive diagnosis and for therapeutic use in general practice will be elucidated.
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Affiliation(s)
- Wolf Axel Langewitz
- Dept. Psychosomatic Medicine, Communication in Medicine (Head: Prof. Sabina Hunziker, MD), University Hospital and University Basel, Hebelstrasse 2, 4031, Basel, Switzerland.
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Vaisvaser S. The Embodied-Enactive-Interactive Brain: Bridging Neuroscience and Creative Arts Therapies. Front Psychol 2021; 12:634079. [PMID: 33995190 PMCID: PMC8121022 DOI: 10.3389/fpsyg.2021.634079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/07/2021] [Indexed: 01/10/2023] Open
Abstract
The recognition and incorporation of evidence-based neuroscientific concepts into creative arts therapeutic knowledge and practice seem valuable and advantageous for the purpose of integration and professional development. Moreover, exhilarating insights from the field of neuroscience coincide with the nature, conceptualization, goals, and methods of Creative Arts Therapies (CATs), enabling comprehensive understandings of the clinical landscape, from a translational perspective. This paper contextualizes and discusses dynamic brain functions that have been suggested to lie at the heart of intra- and inter-personal processes. Touching upon fundamental aspects of the self and self-other interaction, the state-of-the-art neuroscientific-informed views will shed light on mechanisms of the embodied, predictive and relational brain. The conceptual analysis introduces and interweaves the following contemporary perspectives of brain function: firstly, the grounding of mental activity in the lived, bodily experience will be delineated; secondly, the enactive account of internal models, or generative predictive representations, shaped by experience, will be defined and extensively deliberated; and thirdly, the interpersonal simulation and synchronization mechanisms that support empathy and mentalization will be thoroughly considered. Throughout the paper, the cross-talks between the brain and the body, within the brain through functionally connected neural networks and in the context of agent-environment dynamics, will be addressed. These communicative patterns will be elaborated on to unfold psychophysiological linkage, as well as psychopathological shifts, concluding with the neuroplastic change associated with the formulation of CATs. The manuscript suggests an integrative view of the brain-body-mind in contexts relevant to the therapeutic potential of the expressive creative arts and the main avenues by which neuroscience may ground, enlighten and enrich the clinical psychotherapeutic practice.
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Affiliation(s)
- Sharon Vaisvaser
- School of Society and the Arts, Ono Academic College, Kiryat Ono, Israel
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Napadow V. Neuroimaging Somatosensory and Therapeutic Alliance Mechanisms Supporting Acupuncture. Med Acupunct 2020; 32:400-402. [PMID: 33362899 DOI: 10.1089/acu.2020.1497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Acupuncture consists of multiple components, and neuroimaging studies are beginning to tease apart potential brain-based mechanisms supporting this nonpharmacologic intervention. Brain imaging in patient populations is important for the acupuncture neuroimaging field, and recent studies have incorporated neuroimaging into a clinical trial framework for improved ecological validity in extending results to be more relevant for clinical practice. For instance, functional magnetic resonance imaging (fMRI) research with patients suffering from carpal tunnel syndrome has suggested cortical plasticity as a mechanism supporting acupuncture analgesia. In turn, the patient-acupuncturist relationship is another important aspect of acupuncture analgesia, and recent hyperscan fMRI research has begun to explore brain-based mechanisms underlying therapeutic alliance between patient and clinician, and how this might impact acupuncture analgesia. Ultimately, neuroimaging has shown great promise in the past several decades in opening a window into brain function to better appreciate the mechanisms supporting acupuncture. As acupuncture likely operates via multiple distinct mechanisms of action, teasing apart the constituent aspects of acupuncture therapy in humans will be an important goal for current and future neuroimaging research studies.
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Affiliation(s)
- Vitaly Napadow
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
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