RESUMEN
Migraine is a debilitating disorder with limited pharmacological options. Many migraine medications can have intolerable side effects leading patients to seek complementary and integrative health (CIM) approaches for treatment. One option that is growing in popularity and evidence is Acceptance and Commitment Therapy (ACT), a mindfulness-based therapy. The purpose of this paper is to describe how ACT may be an effective modality integrated into the treatment of migraine and to describe the design of a pilot study of ACT for migraine. First, we review the research and the promise of mindfulness therapies for the treatment of migraine. Then, we describe how ACT differs from other mindfulness therapies for migraine and why it can be a promising option for these patients. Finally, we summarize the design of a pilot study designed to determine the feasibility of performing a future fully powered study to determine the effectiveness of ACT on migraine frequency and disability. This pilot study includes unique features, including a remotely-delivered ACT intervention and the measurement of cortisol levels before and after the intervention.
Asunto(s)
Terapia de Aceptación y Compromiso , Trastornos Migrañosos , Atención Plena , Humanos , Hidrocortisona , Trastornos Migrañosos/terapia , Proyectos Piloto , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Mindfulness training can enhance cognitive control, but the neural mechanisms underlying such enhancement in children are unknown. Here, we conducted a randomized controlled trial (RCT) with sixth graders (mean age 11.76 years) to examine the impact of 8 weeks of school-based mindfulness training, relative to coding training as an active control, on sustained attention and associated resting-state functional brain connectivity. At baseline, better performance on a sustained-attention task correlated with greater anticorrelation between the default mode network (DMN) and right dorsolateral prefrontal cortex (DLPFC), a key node of the central executive network. Following the interventions, children in the mindfulness group preserved their sustained-attention performance (i.e., fewer lapses of attention) and preserved DMN-DLPFC anticorrelation compared to children in the active control group, who exhibited declines in both sustained attention and DMN-DLPFC anticorrelation. Further, change in sustained-attention performance correlated with change in DMN-DLPFC anticorrelation only within the mindfulness group. These findings provide the first causal link between mindfulness training and both sustained attention and associated neural plasticity. Administered as a part of sixth graders' school schedule, this RCT supports the beneficial effects of school-based mindfulness training on cognitive control.
Asunto(s)
Atención/fisiología , Conectoma , Red en Modo Predeterminado/fisiología , Corteza Prefontal Dorsolateral/fisiología , Función Ejecutiva/fisiología , Atención Plena , Red Nerviosa/fisiología , Plasticidad Neuronal/fisiología , Niño , Red en Modo Predeterminado/diagnóstico por imagen , Corteza Prefontal Dorsolateral/diagnóstico por imagen , Femenino , Humanos , Masculino , Red Nerviosa/diagnóstico por imagen , Desempeño Psicomotor/fisiologíaRESUMEN
Mammalian olfaction and reproduction are tightly linked, a link less explored in humans. Here, we asked whether human unexplained repeated pregnancy loss (uRPL) is associated with altered olfaction, and particularly altered olfactory responses to body-odor. We found that whereas most women with uRPL could identify the body-odor of their spouse, most control women could not. Moreover, women with uRPL rated the perceptual attributes of men's body-odor differently from controls. These pronounced differences were accompanied by an only modest albeit significant advantage in ordinary, non-body-odor-related olfaction in uRPL. Next, using structural and functional brain imaging, we found that in comparison to controls, most women with uRPL had smaller olfactory bulbs, yet increased hypothalamic response in association with men's body-odor. These findings combine to suggest altered olfactory perceptual and brain responses in women experiencing uRPL, particularly in relation to men's body-odor. Whether this link has any causal aspects to it remains to be explored.
Asunto(s)
Aborto Habitual/fisiopatología , Hipotálamo , Trastornos del Olfato , Bulbo Olfatorio , Olfato/fisiología , Adulto , Femenino , Humanos , Hipotálamo/anatomía & histología , Hipotálamo/diagnóstico por imagen , Hipotálamo/metabolismo , Masculino , Odorantes/análisis , Trastornos del Olfato/diagnóstico por imagen , Trastornos del Olfato/fisiopatología , Bulbo Olfatorio/anatomía & histología , Bulbo Olfatorio/diagnóstico por imagen , Bulbo Olfatorio/metabolismo , Corteza Prefrontal/anatomía & histología , Corteza Prefrontal/diagnóstico por imagen , EmbarazoRESUMEN
Emotional tearing is a poorly understood behavior that is considered uniquely human. In mice, tears serve as a chemosignal. We therefore hypothesized that human tears may similarly serve a chemosignaling function. We found that merely sniffing negative-emotion-related odorless tears obtained from women donors induced reductions in sexual appeal attributed by men to pictures of women's faces. Moreover, after sniffing such tears, men experienced reduced self-rated sexual arousal, reduced physiological measures of arousal, and reduced levels of testosterone. Finally, functional magnetic resonance imaging revealed that sniffing women's tears selectively reduced activity in brain substrates of sexual arousal in men.