Structural differences in the cortex of individuals who experience the autonomous sensory meridian response.

BACKGROUND AND PURPOSE: The autonomous sensory meridian response (ASMR) is a multimodal perceptual phenomenon in which specific sensory triggers evoke tingling sensations on the scalp, neck, and shoulders; these sensations are accompanied by a positive and calming affective state. Previous functional neuroimaging research has shown that ASMR experiences involve medial prefrontal and sensorimotor brain areas. The purpose of the current study was to examine whether there are structural differences in the cortex of individuals who experience ASMR. METHODS: Seventeen individuals with ASMR and 17 matched control participants completed an MPRAGE structural MRI scan. These data were analyzed to determine if group differences were present for measures of cortical thickness, cortical complexity, sulcal depth, and gyrification. RESULTS: ASMR was associated with reduced cortical thickness in a number of regions including the left precuneus, precentral gyrus, and insula, and the right orbitofrontal cortex, superior frontal cortex, and paracentral lobule. Reduced thickness was observed bilaterally in the supramarginal gyrus. Individuals with ASMR also showed less cortical complexity in the pars opercularis and pars triangularis. CONCLUSIONS: The differences in cortical thickness and complexity were in brain areas whose functions relate to the ASMR experience. These differences include neural regions related to phonological processing, sensorimotor functions, and attention.

Tingles down the spinal cord: A spinal functional magnetic resonance imaging investigation of the autonomous sensory meridian response.

Autonomous sensory meridian response (ASMR) is a perceptual and emotional phenomenon in which specific sensory stimuli elicit a feeling of calm as well as tingling sensations on the scalp, neck, and shoulders. In the current study, we use fMRI to examine whether the motoric and sensory regions of the spinal cord segments associated with these body parts show increased activity during ASMR experiences. Nine individuals with ASMR completed six spinal functional magnetic resonance imaging runs while passively viewing videos. Three of the videos were shown (through pre-testing) to elicit ASMR tingles and three videos did not (i.e., control videos). The results demonstrated that ASMR-related stimuli elicited activity in dorsal (sensory) regions of spinal cord segments C1, C5, and C6; activity was observed in ventral (motoric) regions of segments C2-C8. Similar activity was not detected in response to control videos.

Contrasting Mind-Wandering, (Dark) Flow, and Affect During Multiline and Single-Line Slot Machine Play.

Slot machines are a very popular form of gambling in which a small proportion of gamblers experience gambling-related problems. These players refer to a trance-like state that researchers have labelled 'dark flow'-a pleasurable, but maladaptive state where players become completely occupied by the game. We assessed 110 gamblers for mindfulness (using the Mindful Attention Awareness Scale), gambling problems (using the Problem Gambling Severity Index), depressive symptoms (using the Depression, Anxiety, and Stress Scale), and boredom proneness (using the Boredom Proneness Scale). Participants played both a multiline and single-line slot machine simulator and were occasionally interrupted with thought probes to assess whether they were thinking about the game or something else. After playing each game, we retrospectively assessed dark flow and affect during play. Our key results were that the number of "on-game" reports during the multiline game were significantly higher than the single-line game, and that we found significantly greater flow during the multiline game than the single-line game. We also found significantly lower negative affect during the multiline game than the single-line game. Using hierarchical multiple regression, we found that dark flow accounted for unique variance when predicting problem gambling severity (over and above depression, mindfulness, and boredom proneness). These assessments help bolster our previous assertions about escape gambling-if some players are prone to having their mind-wander to negative places, the frequent but unpredictable reinforcement of multiline slot machines may help rein in the wandering mind and prevent minds from unintentionally wandering to negative thoughts.

An electroencephalographic examination of the autonomous sensory meridian response (ASMR).

Autonomous sensory meridian response (ASMR) is a perceptual phenomenon characterized by pleasurable tingling sensations in the head and neck, as well as pleasurable feelings of relaxation, that reliably arise while attending to a specific triggering stimulus (e.g., whispering or tapping sounds). Currently, little is known about the neutral substrates underlying these experiences. In this study, 14 participants who experience ASMR, along with 14 control participants, were presented with four video stimuli and four auditory stimuli. Half of these stimuli were designed to elicit ASMR and half were non-ASMR control stimuli. Brain activity was measured using a 32-channel EEG system. The results indicated that ASMR stimuli-particularly auditory stimuli-elicited increased alpha wave activity in participants with self-reported ASMR, but not in matched control participants. Similar increases were also observed in frequency bands associated with movement (gamma waves and sensorimotor rhythm). These results are consistent with the reported phenomenology of ASMR, which involves both attentional and sensorimotor characteristics.

Using deliberate mind-wandering to escape negative mood states: Implications for gambling to escape.

BACKGROUND AND AIMS: Slot machines are a pervasive form of gambling in North America. Some gamblers describe entering "the slot machine zone"-a complete immersion into slots play to the exclusion of all else. METHODS: We assessed 111 gamblers for mindfulness (using the Mindful Attention Awareness Scale (MAAS)), gambling problems (using the Problem Gambling Severity Index (PGSI)), depressive symptoms (using the Depression, Anxiety, and Stress Scale), and boredom proneness (using the Boredom Proneness Scale). In a counterbalanced order, participants played a slot machine simulator and completed an auditory vigilance task. During each task, participants were interrupted with thought probes to assess whether they were: on-task, spontaneously mind-wandering, or deliberately mind-wandering. After completing each task, we retrospectively assessed flow and affect. Compared to the more exciting slots play, we propose that gamblers may use deliberate mind-wandering as a maladaptive means to regulate affect during a repetitive vigilance task. RESULTS: Our key results were that gamblers reported greater negative affect following the vigilance task (when compared to slots) and greater positive affect following slots play (when compared to the vigilance task). We also found that those who scored higher in problem gambling were more likely to use deliberate mind-wandering as a means to cope with negative affect during the vigilance task. Using hierarchical multiple regression, we found that the number of "deliberately mind-wandering" responses accounted for unique variance when predicting problem gambling severity (over and above depression, mindfulness, and boredom proneness). CONCLUSIONS: These assessments highlight a potential coping mechanism used by problem gamblers in order to deal with negative affect.

Functional connectivity associated with five different categories of Autonomous Sensory Meridian Response (ASMR) triggers.

Autonomous sensory meridian response (ASMR) is a sensory-emotional phenomenon in which specific sensory stimuli ("ASMR triggers") reliably elicit feelings of relaxation and tingling sensations on the head, neck, and shoulders. However, there are individual differences in which stimuli elicit ASMR and in the intensity of these responses. In the current research, we used resting-state fMRI to examine the functional connectivity associated with these differences. Fifteen individuals with self-reported ASMR completed the ASMR Checklist, which measures sensitivity to different ASMR triggers, and a resting-state fMRI scan. Checklist scores were entered as covariates to determine whether the functional connectivity of eight resting-state networks differed as a function of participants' sensitivity to five categories of triggers. The results indicated unique patterns of functional connectivity associated with sensitivity to each ASMR trigger category. Sensitivity to two trigger categories was positively correlated with the dorsal attention network, suggesting that ASMR may involve atypical attentional processing.

Considerations for Managing Patients With Hematologic Malignancy During the COVID-19 Pandemic: The Seattle Strategy.

In January 2020, the first documented patient in the United States infected with severe acute respiratory syndrome coronavirus 2 was diagnosed in Washington State. Since that time, community spread of coronavirus disease 2019 (COVID-19) in the state has changed the practice of oncologic care at our comprehensive cancer center in Seattle. At the Seattle Cancer Care Alliance, the primary oncology clinic for the University of Washington/Fred Hutchinson Cancer Consortium, our specialists who manage adult patients with hematologic malignancies have rapidly adjusted clinical practices to mitigate the potential risks of COVID-19 to our patients. We suggest that our general management decisions and modifications in Seattle are broadly applicable to patients with hematologic malignancies. Despite a rapidly changing environment that necessitates opinion-based care, we provide recommendations that are based on best available data from clinical trials and collective knowledge of disease states.

Impact of Double- or Triple-Hit Pathology on Rates and Durability of Radiation Therapy Response Among Patients With Relapsed or Refractory Large B-Cell Lymphoma.

PURPOSE: Double-hit lymphomas and triple-hit lymphomas (DHL/THL), also known as high-grade B-cell lymphoma with MYC and BCL2 or BCL6 rearrangements, are associated with chemoresistance and inferior survival. However, whether radiation therapy (RT) efficacy is altered in DHL/THL is less well characterized. Among patients with relapsed or refractory large B-cell lymphoma (R/R LBCL), we compared rates and durability of response between patients with and without DHL/THL. METHODS AND MATERIALS: We retrospectively reviewed consecutive R/R LBCL patients who were irradiated at a single institution from January 2008 to June 2017. Patients in whom c-MYC rearranged status was known were evaluated for response to RT, in-field control, progression-free, and overall survival. RESULTS: Among 245 irradiated patients with LBCL, 41 patients with confirmed c-MYC status were treated for R/R disease (14 DHL/THL, 27 non-DHL/THL) and formed our cohort. Compared with non-DHL/THL, more DHL/THL patients had progressive disease at RT (71% vs 48%), had larger gross tumor volumes (GTV; median 696 mL vs 117 mL), and were treated with palliative intent (71% vs 41%). Despite similar RT doses (median 35 Gy), radiographic complete response rate was lower among DHL/THL patients: 14.3% versus 64.7% (P = .01). With a median 2 years of follow-up, one in-field failure was observed in each group. DHL/THL patients had inferior progression-free survival (7% vs 46%; P = .02) and overall survival (14% vs 68%; P = .03) at 6 months. CONCLUSIONS: R/R LBCL is responsive to RT, although rates of response are lower among DHL/THL patients. Given poor survival after RT, in-field control was hard to evaluate in this cohort. Larger cohorts are required to better elucidate whether differences in response rates are driven by larger disease burden at RT versus tumor biology. These findings are of increasing pertinence in light of use of RT as bridging therapy to cellular immunotherapies.

Trait Mindfulness and Functional Connectivity in Cognitive and Attentional Resting State Networks.

Mindfulness has been described as an orienting of attention to the present moment, with openness and compassion. Individuals displaying high trait mindfulness exhibit this tendency as a more permanent personality attribute. Given the numerous physical and mental health benefits associated with mindfulness, there is a great interest in understanding the neural substrates of this trait. The purpose of the current research was to examine how individual differences in trait mindfulness associated with functional connectivity in five resting-state networks related to cognition and attention: the default mode network (DMN), the salience network (SN), the central executive network (CEN), and the dorsal and ventral attention networks (DAN and VAN). Twenty-eight undergraduate participants completed the Five-Facet Mindfulness Questionnaire (FFMQ), a self-report measure of trait mindfulness which also provides scores on five of its sub-categories (Observing, Describing, Acting with Awareness, Non-judging of Inner Experience, and Non-reactivity to Inner Experience). Participants then underwent a structural MRI scan and a 7-min resting state functional MRI scan. Resting-state data were analyzed using independent-component analyses. An analysis of covariance (ANCOVA) was performed to determine the relationship between each resting state network and each FFMQ score. These analyses indicated that: (1) trait mindfulness and its facets showed increased functional connectivity with neural regions related to attentional control, interoception, and executive function; and (2) trait mindfulness and its facets showed decreased functional connectivity with neural regions related to self-referential processing and mind wandering. These patterns of functional connectivity are consistent with some of the benefits of mindfulness-enhanced attention, self-regulation, and focus on present experience. This study provides support for the notion that non-judgmental attention to the present moment facilitates the integration of regions in neural networks that are related to cognition, attention, and sensation.

Mindfulness and autonomous sensory meridian response (ASMR).

BACKGROUND: Autonomous sensory meridian response (ASMR) is a perceptual phenomenon in which specific audiovisual stimuli frequently elicit tingling sensations on the scalp and neck. These stimuli ("ASMR triggers") are typically social in nature (e.g., watching someone brush their hair, hearing whispering,) and often elicit a calm and positive emotional state that may last up to several minutes. ASMR experiences phenomenologically overlap with mindfulness; however, no research has directly examined how mindfulness might relate to ASMR. METHODS: In the current study, 284 individuals with ASMR completed the Toronto Mindfulness Scale (TMS), the Mindful Attention and Awareness Scale (MAAS), and a questionnaire examining ASMR experiences. Age- and sex-matched control participants were asked to view two ASMR-eliciting videos to ensure that they did not experience tingling sensations associated with ASMR; they then completed the TMS and MAAS questionnaires. RESULTS: When compared with matched controls, individuals with ASMR generated significantly higher scores on the MAAS, a global measure of mindfulness, as well as significantly higher scores on the Curiosity subscale of the TMS. CONCLUSIONS: These results suggest that the sensory-emotional experiences associated with ASMR may be partially explained by a distinct subset of characteristics associated with mindfulness.

Resting-State Network Functional Connectivity Patterns Associated with the Mindful Attention Awareness Scale.

Mindfulness refers to attending to moment-to-moment experiences with acceptance and no judgment. Several scales have been developed to quantify different components of mindfulness. The Mindful Attention Awareness Scale (MAAS) is particularly sensitive to trait mindfulness and is proposed to measure the attentional component of mindfulness. The purpose of this study was to identify the neural correlates of the MAAS in four resting-state networks related to attention-the default mode network (DMN), the salience network (SN), and the left and right central executive network (CEN). Thirty-two university students naive to mindfulness completed the MAAS and later underwent a resting-state functional magnetic resonance imaging scan. Resting-state data were analyzed using an independent component analysis; the scores from the MAAS were covaried to the connectivity maps in an analysis of covariance. The results indicate that variations in MAAS scores correlated with variations in functional connectivity patterns in resting-state networks. Specifically, within the SN and CEN, the MAAS was negatively correlated with functional connectivity in the precuneus, even though the precuneus is a key component of the DMN. Negative correlations in the DMN between the MAAS and the insula and negative correlations in the SN between the MAAS and the posterior cingulate cortex were also observed. These results suggest that MAAS scores (1) are correlated with the functional connectivity of several brain structures related to attention and (2) involve cross-network functional connectivity.

Striatal dopamine transmission in healthy humans during a passive monetary reward task.

Research on dopamine (DA) transmission has emphasized the importance of increased phasic DA cell firing in the presence of unpredictable rewards. Using [(11)C]raclopride PET, we previously reported that DA transmission was both suppressed and enhanced in different regions of the striatum during an unpredictable reward task [Zald, D.H., Boileau, I., El Dearedy, W., Gunn, R., McGlone, F., Dichter, G.S. et al. (2004). Dopamine transmission in the human striatum during monetary reward tasks. J. Neurosci. 24, 4105-4112]. However, it was unclear if reductions in DA release during this task reflected a response to the high proportion of nonrewarding trials, and whether the behavioral demands of the task influenced the observed response. To test these issues, we presented 10 healthy subjects with an automated (passive) roulette wheel game in which the amount of reward and its timing were unpredictable and the rewarding trials greatly outnumbered the nonrewarding ones. As in the previous study, DA transmission in the putamen was significantly suppressed relative to a predictable control condition. A similar suppression occurred when subjects were presented with temporally unpredictable novel pictures and sounds. At present, models of DA functioning during reward do not account for this suppression, but given that it has been observed in two different studies using different reward paradigms, this phenomenon warrants attention. Neither the unpredictable reward nor the novelty conditions produced consistent increases in striatal DA transmission. These data suggest that active behavioral engagement may be necessary to observe robust statewise increases in DA release in the striatum.