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Strigo IA, Craig ADB, Simmons AN. Expectation of pain and relief: a dynamical model of the neural basis for pain-trauma co-morbidity. Neurosci Biobehav Rev 2024:105750. [PMID: 38849067 DOI: 10.1016/j.neubiorev.2024.105750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/30/2024] [Accepted: 06/02/2024] [Indexed: 06/09/2024]
Abstract
Posttraumatic Stress Disorder (PTSD) is highly co-morbid with chronic pain conditions. When present, PTSD significantly worsens chronic pain outcomes. Likewise, pain contributes to a more severe PTSD as evidenced by greater disability, more frequent use of harmful opioid analgesics and increased pain severity. The biomechanism behind this comorbidity is incompletely understood, however recent work strongly supports the widely-accepted role of expectation, in the entanglement of chronic pain and trauma symptoms. This work has shown that those with trauma have a maladaptive brain response while expecting stress and pain, whereas those with chronic pain may have a notable impairment in brain response while expecting pain relief. This dynamical expectation model of the interaction between neural systems underlying expectation of pain onset (traumatic stress) and pain offset (chronic pain) is biologically viable and may provide a biomechanistic insight into pain-trauma comorbidity. These predictive mechanisms work through interoceptive pathways in the brain critically the insula cortex. Here we highlight how the neural expectation-related mechanisms augment the existing models of pain and trauma to better understand the dynamics of pain and trauma comorbidity. These ideas will point to targeted complementary clinical approaches, based on mechanistically separable neural biophenotypes for the entanglement of chronic pain and trauma symptoms.
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Affiliation(s)
- Irina A Strigo
- Emotion and Pain Laboratory, San Francisco Veterans Affairs Health Care Center, 4150 Clement Street, San Francisco, CA 94121, USA; Department of Psychiatry, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA
| | - A D Bud Craig
- Emotion and Pain Laboratory, San Francisco Veterans Affairs Health Care Center, 4150 Clement Street, San Francisco, CA 94121, USA; Department of Psychiatry, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA; Center of Excellence in Stress and Mental Health, San Diego Veterans Affairs Health Care Center, 3350 La Jolla Village Dr, San Diego, CA 92161, USA; Stress and Neuroimaging Laboratory, San Diego Veterans Affairs Health Care Center, 3350 La Jolla Village Drive, MC 151-B, San Diego, CA 92161, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA
| | - Alan N Simmons
- Center of Excellence in Stress and Mental Health, San Diego Veterans Affairs Health Care Center, 3350 La Jolla Village Dr, San Diego, CA 92161, USA; Stress and Neuroimaging Laboratory, San Diego Veterans Affairs Health Care Center, 3350 La Jolla Village Drive, MC 151-B, San Diego, CA 92161, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA
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2
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Bonetti L, Fernández-Rubio G, Carlomagno F, Dietz M, Pantazis D, Vuust P, Kringelbach ML. Spatiotemporal brain hierarchies of auditory memory recognition and predictive coding. Nat Commun 2024; 15:4313. [PMID: 38773109 PMCID: PMC11109219 DOI: 10.1038/s41467-024-48302-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 04/25/2024] [Indexed: 05/23/2024] Open
Abstract
Our brain is constantly extracting, predicting, and recognising key spatiotemporal features of the physical world in order to survive. While neural processing of visuospatial patterns has been extensively studied, the hierarchical brain mechanisms underlying conscious recognition of auditory sequences and the associated prediction errors remain elusive. Using magnetoencephalography (MEG), we describe the brain functioning of 83 participants during recognition of previously memorised musical sequences and systematic variations. The results show feedforward connections originating from auditory cortices, and extending to the hippocampus, anterior cingulate gyrus, and medial cingulate gyrus. Simultaneously, we observe backward connections operating in the opposite direction. Throughout the sequences, the hippocampus and cingulate gyrus maintain the same hierarchical level, except for the final tone, where the cingulate gyrus assumes the top position within the hierarchy. The evoked responses of memorised sequences and variations engage the same hierarchical brain network but systematically differ in terms of temporal dynamics, strength, and polarity. Furthermore, induced-response analysis shows that alpha and beta power is stronger for the variations, while gamma power is enhanced for the memorised sequences. This study expands on the predictive coding theory by providing quantitative evidence of hierarchical brain mechanisms during conscious memory and predictive processing of auditory sequences.
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Affiliation(s)
- L Bonetti
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music, Aarhus/Aalborg, Denmark.
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, United Kingdom.
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
- Department of Psychology, University of Bologna, Bologna, Italy.
| | - G Fernández-Rubio
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music, Aarhus/Aalborg, Denmark
| | - F Carlomagno
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music, Aarhus/Aalborg, Denmark
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - M Dietz
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - D Pantazis
- McGovern Institute for Brain Research, Massachusetts Institute of Technology (MIT), Cambridge, MA, 02139, USA
| | - P Vuust
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music, Aarhus/Aalborg, Denmark
| | - M L Kringelbach
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music, Aarhus/Aalborg, Denmark
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Lucherini Angeletti L, Cassioli E, Tarchi L, Dani C, Faldi M, Martini R, Ricca V, Castellini G, Rossi E. From early relational experiences to non-suicidal self-injury in anorexia and bulimia nervosa: a structural equation model unraveling the role of impairments in interoception. Eat Weight Disord 2024; 29:22. [PMID: 38528258 DOI: 10.1007/s40519-024-01651-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 03/17/2024] [Indexed: 03/27/2024] Open
Abstract
PURPOSE Individuals with anorexia nervosa (AN) and bulimia nervosa (BN) frequently exhibit Non-Suicidal Self-Injury (NSSI), yet their co-occurrence is still unclear. To address this issue, the aim of this study was to elucidate the role of impairments in interoception in explaining the NSSI phenomenon in AN and BN, providing an explanatory model that considers distal (insecure attachment/IA and traumatic childhood experiences/TCEs) and proximal (dissociation and emotional dysregulation) risk factors for NSSI. METHOD 130 patients with AN and BN were enrolled and administered self-report questionnaires to assess the intensity of NSSI behaviors, interoceptive deficits, IA, TCEs, emotional dysregulation and dissociative symptoms. RESULTS Results from structural equation modeling revealed that impairments in interoception acted as crucial mediators between early negative relational experiences and factors that contribute to NSSI in AN and BN, particularly emotional dysregulation and dissociation. Precisely, both aspects of IA (anxiety and avoidance) and various forms of TCEs significantly exacerbated interoceptive deficits, which in turn are associated to the emergence of NSSI behaviors through the increase in levels of dissociation and emotional dysregulation. CONCLUSIONS The proposed model provided a novel explanation of the occurrence of NSSIs in patients with AN and BN by accounting for the significance of interoception. LEVEL OF EVIDENCE Level V-Cross-sectional observational study.
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Affiliation(s)
- Lorenzo Lucherini Angeletti
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy.
- The Royal's Institute of Mental Health Research & University of Ottawa, Ottawa, ON, Canada.
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy
| | - Livio Tarchi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy
| | - Cristiano Dani
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy
| | - Marco Faldi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy
| | - Rachele Martini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy.
| | - Eleonora Rossi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy
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Scalabrini A, Cavicchioli M, Benedetti F, Mucci C, Northoff G. The nested hierarchical model of self and its non-relational vs relational posttraumatic manifestation: an fMRI meta-analysis of emotional processing. Mol Psychiatry 2024:10.1038/s41380-024-02520-w. [PMID: 38514803 DOI: 10.1038/s41380-024-02520-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
Different kinds of traumatic experiences like natural catastrophes vs. relational traumatic experiences (e.g., sex/physical abuse, interpersonal partner violence) are involved in the development of the self and PTSD psychopathological manifestations. Looking at a neuroscience approach, it has been proposed a nested hierarchical model of self, which identifies three neural-mental networks: (i) interoceptive; (ii) exteroceptive; (iii) mental. However, it is still unclear how the self and its related brain networks might be affected by non-relational vs relational traumatic experiences. Departing from this background, the current study aims at conducting a meta-analytic review of task-dependent fMRI studies (i.e., emotional processing task) among patients with PTSD due to non-relational (PTSD-NR) and relational (PTSD-R) traumatic experiences using two approaches: (i) a Bayesian network meta-analysis for a region-of-interest-based approach; (ii) a coordinated-based meta-analysis. Our findings suggested that the PTSD-NR mainly recruited areas ascribed to the mental self to process emotional stimuli. Whereas, the PTSD-R mainly activated regions associated with the intero-exteroceptive self. Accordingly, the PTSD-R compared to the PTSD-NR might not reach a higher symbolic capacity to process stimuli with an emotional valence. These results are also clinically relevant in support of the development of differential treatment approaches for non-relational vs. relational PTSD.
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Affiliation(s)
- Andrea Scalabrini
- Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino, 2, Bergamo, 24129, Italy.
| | - Marco Cavicchioli
- University Vita- Salute San Raffaele, Milan, Via Olgettina, 58, Milan, 20132, Italy.
| | - Francesco Benedetti
- University Vita- Salute San Raffaele, Milan, Via Olgettina, 58, Milan, 20132, Italy
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona, 20, 20127, Milan, Italy
| | - Clara Mucci
- Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino, 2, Bergamo, 24129, Italy
| | - Georg Northoff
- The Royal's Institute of Mental Health Research & University of Ottawa. Brain and Mind Research Institute, Centre for Neural Dynamics, Faculty of Medicine, University of Ottawa, Ottawa, 145 Carling Avenue, Rm. 6435, Ottawa, ON, K1Z 7K412, Canada
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5
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Di Plinio S, Arnò S, Ebisch SJH. The state-trait sense of self inventory: A psychometric study of self-experience and its relation to psychosis-like manifestations. Conscious Cogn 2024; 118:103634. [PMID: 38215634 DOI: 10.1016/j.concog.2024.103634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/23/2023] [Accepted: 01/01/2024] [Indexed: 01/14/2024]
Abstract
The sense of self is a fundamental construct in the study of the mind, yet its psychological nature remains elusive. We introduce a novel 25-item inventory to investigate selfhood both as an enduring trait and a temporary state. We hypothesized two foundational aspects of the self: identity (related to self-referencing and continuity over time) and agency (the perception of controlling own's actions and thoughts). Results from two population studies highlight a singular self-trait factor combining agency and identity. In contrast, self-state measures revealed a bifactorial structure with a high-order factor and three lower-order subfactors: state-identity, state-agency, and state-technology. These factors were predictive of psychosis-like experiences, schizotypal traits, and hopelessness. Mediation analysis demonstrated that the negative association between the sense of self and hopelessness is mediated by depressive manifestations. Our research provides a tool to shed new light on the complexity of the sense of self and its mental health implications.
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Affiliation(s)
- Simone Di Plinio
- University G D'Annunzio of Chieti-Pescara, Department of Neuroscience, Imaging, and Clinical Science, Italy.
| | - Simone Arnò
- University G D'Annunzio of Chieti-Pescara, Department of Neuroscience, Imaging, and Clinical Science, Italy
| | - Sjoerd J H Ebisch
- University G D'Annunzio of Chieti-Pescara, Department of Neuroscience, Imaging, and Clinical Science, Italy
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Scalabrini A, De Amicis M, Brugnera A, Cavicchioli M, Çatal Y, Keskin K, Pilar JG, Zhang J, Osipova B, Compare A, Greco A, Benedetti F, Mucci C, Northoff G. The self and our perception of its synchrony - Beyond internal and external cognition. Conscious Cogn 2023; 116:103600. [PMID: 37976779 DOI: 10.1016/j.concog.2023.103600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/23/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
The self is the core of our mental life which connects one's inner mental life with the external perception. Since synchrony is a key feature of the biological world and its various species, what role does it play for humans? We conducted a large-scale psychological study (n = 1072) combining newly developed visual analogue scales (VAS) for the perception of synchrony and internal and external cognition complemented by several psychological questionnaires. Overall, our findings showed close connection of the perception of synchrony of the self with both internal (i.e., body and cognition) and external (i.e., others, environment/nature) synchrony being associated positively with adaptive and negatively with maladaptive traits of self. Moreover, we have demonstrated how external (i.e., life events like the COVID-19 pandemic) variables modulate the perception of the self's internal-external synchrony. These findings suggest how synchrony with self plays a central role during times of uncertainty.
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Affiliation(s)
- Andrea Scalabrini
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.
| | | | - Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | | | - Yasir Çatal
- The Royal's Institute of Mental Health Research & University of Ottawa. Brain and Mind Research Institute, Centre for Neural Dynamics, Faculty of Medicine, University of Ottawa, Ottawa, 145 Carling Avenue, Rm. 6435, Ottawa, Ontario K1Z 7K4, Canada; Department of Cellular and Molecular Medicine University of Ottawa, Ottawa, Canada
| | - Kaan Keskin
- Ege University Faculty of Medicine, Department of Psychiatry, 35100 Bornova-İzmir, Turkey
| | - Javier Gomez Pilar
- Biomedical Engineering Group, University of Valladolid, Valladolid, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER‑BBN), Valladolid, Spain
| | - Jianfeng Zhang
- Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen 518055, Guangdong Province, China
| | - Bella Osipova
- Moscow State University of Psychology and Education (MSUPE)
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Andrea Greco
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Francesco Benedetti
- University Vita- Salute San Raffaele, Milan, Italy; Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Clara Mucci
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Georg Northoff
- University Vita- Salute San Raffaele, Milan, Italy; The Royal's Institute of Mental Health Research & University of Ottawa. Brain and Mind Research Institute, Centre for Neural Dynamics, Faculty of Medicine, University of Ottawa, Ottawa, 145 Carling Avenue, Rm. 6435, Ottawa, Ontario K1Z 7K4, Canada; Mental Health Centre, Zhejiang University School of Medicine, Tianmu Road 305, Hangzhou, Zhejiang Province 310013, China; Centre for Cognition and Brain Disorders, Hangzhou Normal University, Tianmu Road 305, Hangzhou, Zhejiang Province 310013, China.
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Scalabrini A, Palladini M, Mazza MG, Mucci C, Northoff G, Benedetti F. In Between the Psychological and Physiological Self - The Impact of Covid-19 Pandemic on the Neuro-Socio-Ecological and Inflammatory Mind-Body-Brain System. CLINICAL NEUROPSYCHIATRY 2023; 20:342-350. [PMID: 37791086 PMCID: PMC10544257 DOI: 10.36131/cnfioritieditore20230414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
The COVID-19 pandemic has had a profound impact on individuals' sense of self perturbating the sense of connectedness with the others, touching upon deep existential fears and deep intersubjective and cultural layers, emphasizing the importance of a neuro-socio-ecological alignment for the sense of security of psychological self. We can still observe after years how social distancing measures, quarantines, and lockdowns have disrupted social connections and routines, leading to feelings of isolation, anxiety and depressive symptomatology. Furthermore, from a physiological perspective, some people continue to experience health problems long after having COVID-19, and these ongoing health problems are sometimes called post-COVID-19 syndrome or post-COVID conditions (PASC). In this complex scenario, through the operationalization of the sense of self and its psychological and physiological baseline, our aim is to try to shed some new light on elements of resilience vs. vulnerability. Here we intend the self and its baseline as the crossroads between psychology and physiology and we show how COVID-19 pandemic, especially in post-COVID-19 syndrome (PACS), left traces in the mind-body-brain system at a neuro-socio-ecological and inflammatory level.
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Affiliation(s)
- Andrea Scalabrini
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Mariagrazia Palladini
- University Vita- Salute San Raffaele, Milan, Italy
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mario Gennaro Mazza
- University Vita- Salute San Raffaele, Milan, Italy
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Clara Mucci
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Georg Northoff
- The Royal’s Institute of Mental Health Research & University of Ottawa. Brain and Mind Research Institute, Centre for Neural Dynamics, Faculty of Medicine, University of Ottawa, Ottawa, 145 Carling Avenue, Rm. 6435, Ottawa, Ontario, Canada K1Z 7K412
- Mental Health Centre, Zhejiang University School of Medicine, Tianmu Road 305, Hangzhou, Zhejiang Province, 310013, China
- Centre for Cognition and Brain Disorders, Hangzhou Normal University, Tianmu Road 305, Hangzhou, Zhejiang Province, 310013, China
| | - Francesco Benedetti
- University Vita- Salute San Raffaele, Milan, Italy
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Northoff G, Scalabrini A, Fogel S. Topographic-dynamic reorganisation model of dreams (TRoD) - A spatiotemporal approach. Neurosci Biobehav Rev 2023; 148:105117. [PMID: 36870584 DOI: 10.1016/j.neubiorev.2023.105117] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/13/2022] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
Dreams are one of the most bizarre and least understood states of consciousness. Bridging the gap between brain and phenomenology of (un)conscious experience, we propose the Topographic-dynamic Re-organization model of Dreams (TRoD). Topographically, dreams are characterized by a shift towards increased activity and connectivity in the default-mode network (DMN) while they are reduced in the central executive network, including the dorsolateral prefrontal cortex (except in lucid dreaming). This topographic re-organization is accompanied by dynamic changes; a shift towards slower frequencies and longer timescales. This puts dreams dynamically in an intermediate position between awake state and NREM 2/SWS sleep. TRoD proposes that the shift towards DMN and slower frequencies leads to an abnormal spatiotemporal framing of input processing including both internally- and externally-generated inputs (from body and environment). In dreams, a shift away from temporal segregation to temporal integration of inputs results in the often bizarre and highly self-centric mental contents as well as hallucinatory-like states. We conclude that topography and temporal dynamics are core features of the TroD, which may provide the connection of neural and mental activity, e.g., brain and experience during dreams as their "common currency".
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Affiliation(s)
- Georg Northoff
- Faculty of Medicine, Centre for Neural Dynamics, The Royal's Institute of Mental Health Research, Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada; Mental Health Centre, Zhejiang University School of Medicine, Hangzhou, China; Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China.
| | - Andrea Scalabrini
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.
| | - Stuart Fogel
- Sleep and Neuroscience, The Royal's Institute of Mental Health Research, Brain and Mind Research Institute and Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada.
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Cera N, Monteiro J, Esposito R, Di Francesco G, Cordes D, Caldwell JZK, Cieri F. Neural correlates of psychodynamic and non-psychodynamic therapies in different clinical populations through fMRI: A meta-analysis and systematic review. Front Hum Neurosci 2022; 16:1029256. [PMID: 36644207 PMCID: PMC9832372 DOI: 10.3389/fnhum.2022.1029256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Abstract
Background The COVID-19 pandemic has exacerbated the ongoing crisis in psychiatric and psychological care, contributing to what we have identified as a new psychological and psychiatric pandemic. Psychotherapy is an effective method for easing the psychological suffering experienced also by the various impacts of COVID-19. This treatment can be examined from a neurological perspective, through the application of brain imaging techniques. Specifically, the meta-analysis of imaging studies can aid in expanding researchers' understanding of the many beneficial applications of psychotherapy. Objectives We examined the functional brain changes accompanying different mental disorders with functional Magnetic Resonance Imaging (fMRI), through a meta-analysis, and systematic review in order to better understand the general neural mechanism involved in psychotherapy and the potential neural difference between psychodynamic and non-psychodynamic approaches. Data sources The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were employed for our systematic review and meta-analysis. We conducted a computer-based literature search, following the Population, Intervention, Comparison and Outcomes (PICO) approach, to retrieve all published articles in English regarding the above-described topics from PubMed (MEDLINE), Scopus, and Web of Science. Study eligibility criteria participants and interventions We combined terms related to psychotherapy and fMRI: ("psychotherapy" [All Fields] OR "psychotherapy" [MeSH Terms] OR "psychotherapy" [All Fields] OR "psychotherapies" [All Fields] OR "psychotherapy s" [All Fields]) AND ("magnetic resonance imaging" [MeSH Terms]) OR ("magnetic"[All Fields] AND "resonance"[All Fields] AND "imaging"[All Fields]) OR ("magnetic resonance imaging"[All Fields] OR "fmri"[All Fields]). We considered (1) whole brain fMRI studies; (2) studies in which participants have been involved in a clinical trial with psychotherapy sessions, with pre/post fMRI; (3) fMRI results presented in coordinate-based (x, y, and z) in MNI or Talairach space; (4) presence of neuropsychiatric patients. The exclusion criteria were: (1) systematic review or meta-analysis; (2) behavioral study; (3) single-case MRI or fMRI study; and (4) other imaging techniques (i.e., PET, SPECT) or EEG. Results After duplicates removal and assessment of the content of each published study, we included 38 sources. The map including all studies that assessed longitudinal differences in brain activity showed two homogeneous clusters in the left inferior frontal gyrus, and caudally involving the anterior insular cortex (p < 0.0001, corr.). Similarly, studies that assessed psychotherapy-related longitudinal changes using emotional or cognitive tasks (TASK map) showed a left-sided homogeneity in the anterior insula (p < 0.000) extending to Broca's area of the inferior frontal gyrus (p < 0.0001) and the superior frontal gyrus (p < 0.0001). Studies that applied psychodynamic psychotherapy showed Family-Wise Error (FWE) cluster-corrected (p < 0.05) homogeneity values in the right superior and inferior frontal gyri, with a small cluster in the putamen. No FWE-corrected homogeneity foci were observed for Mindful- based and cognitive behavioral therapy psychotherapy. In both pre- and post-therapy results, studies showed two bilateral clusters in the dorsal anterior insulae (p = 0.00001 and p = 0.00003, respectively) and involvement of the medial superior frontal gyrus (p = 0.0002). Limitations Subjective experiences, such as an individual's response to therapy, are intrinsically challenging to quantify as objective, factual realities. Brain changes observed both pre- and post-therapy could be related to other factors, not necessary to the specific treatment received. Therapeutic modalities and study designs are generally heterogeneous. Differences exist in sample characteristics, such as the specificity of the disorder and number and duration of sessions. Moreover, the sample size is relatively small, particularly due to the paucity of studies in this field and the little contribution of PDT. Conclusions and implications of key findings All psychological interventions seem to influence the brain from a functional point of view, showing their efficacy from a neurological perspective. Frontal, prefrontal regions, insular cortex, superior and inferior frontal gyrus, and putamen seem involved in these neural changes, with the psychodynamic more linked to the latter three regions.
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Affiliation(s)
- Nicoletta Cera
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- CIBIT-Coimbra Institute for Biomedical Imaging and Translational Research, Coimbra, Portugal
| | - Jessica Monteiro
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Roberto Esposito
- Department of Radiology, Area Vasta 1/ASUR Marche, Pesaro, Italy
| | | | - Dietmar Cordes
- Department of Neurology, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
- Department of Brain Health, University of Nevada, Las Vegas, NV, United States
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, United States
| | - Jessica Z. K. Caldwell
- Department of Neurology, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
| | - Filippo Cieri
- Department of Neurology, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
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10
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An integrative perspective on the role of touch in the development of intersubjectivity. Brain Cogn 2022; 163:105915. [PMID: 36162247 DOI: 10.1016/j.bandc.2022.105915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022]
Abstract
Touch concerns a fundamental component of sociality. In this review, we examine the hypothesis that somatomotor development constitutes a crucial psychophysiological element in the ontogeny of intersubjectivity. An interdisciplinary perspective is provided on how the communication channel of touch contributes to the sense of self and extends to the social self. During gestation, the transformation of random movements into organized sequences of actions with sensory consequences parallels the development of the brain's functional architecture. Brain subsystems shaped by the coordinated activity of somatomotor circuits to support these first body-environment interactions are the first brain functional arrangements to develop. We propose that tactile self-referring behaviour during gestation constitutes a prototypic mode of interpersonal exchange that supports the subsequent development of intersubjective exchange. The reviewed research suggests that touch constitutes a pivotal bodily experience that in early stages builds and later filters self-other interactions. This view is corroborated by the fact that aberrant social-affective touch experiences appear fundamentally associated with attachment anomalies, interpersonal trauma, and personality disorders. Given the centrality of touch for the development of intersubjectivity and for psychopathological conditions in the social domain, dedicated research is urged to elucidate the role of touch in the evolution of subjective self-other coding.
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