Autonomic nervous system function before and after trauma-focused psychotherapy in youth with (partial) posttraumatic stress disorder.

While trauma-focused psychotherapies have been shown effective in youth with PTSD, the relationship between treatment response and alterations in the autonomic nervous system (ANS) associated with PTSD, remains incompletely understood. During neutral and personalized trauma script imagery heart rate (HR), pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA) were recorded in youth aged 8-18 with PTSD or partial PTSD (n = 76) and trauma-exposed controls (TEC) (n = 27) to determine ANS activity and stress reactivity. Within the patient group, 77.6% met the full DSM-IV diagnostic criteria for PTSD, the remaining 22.4% met the criteria for partial PTSD. Youth with (partial) PTSD were subsequently treated with eight sessions of either trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing. PTSD severity was assessed using the Clinician-Administered PTSD scale for Children and Adolescents to divide patients into responders and non-responders. Youth with (partial) PTSD relative to TEC had higher overall HR during both neutral and trauma imagery (p = .05). Youth with (partial) PTSD showed RSA decrease during trauma imagery relative to neutral imagery, the reverse of TEC (p = .01). Relative to non-responders, responders demonstrated a significant baseline to posttreatment increase of RSA response to stress only when employing a ≥ 50% response criterion (p = .05) and not with the primary ≥ 30% criterion (p = .12). Our results suggest overall higher HR and sympathetic nervous system activity as well as vagal withdrawal in response to stress in youth with (partial) PTSD and only provide partial support for normalization of the latter with successful trauma-focused psychotherapy.

Sistema nervoso autônomo: simpático e parassimpático: um livro-mestre, dysautomia prática, soluções e tratamentos / Autonomic nervous system: sympathetic and parasympathetic: a master book, practical dysautonomia, solutions and treatments

O Sistema Nervoso Autônomo (SNA), com as suas divisões simpático e parassimpático, no meu sentir, é o grande maestro que rege essa orquesta maravilhosa que é o ser vivente e, entre outras coisas, dá pistas das gêneses das doenças, conforme o seu tônus seja simpato ou parasimpatomimético, com as suas peculiaridades. Exercendo esta função de maestro, ele modula o que entra e sai do organismo associado ao sistema endócrino. Essa parceria neuroendócrina comanda não somente a vida vegetativa como também a vida de relação. A harmonia do organismo: em cima, embaixo, dentro e fora, bem como entre as lateralidades direita e esquerda, passam pela influência do SNA, mais precisamente pela função neuroendócrina. O SNA possibilita ainda perceber com antecedência que o provável evoluir das doenças medicadas por quaisquer estratégias terapêuticas que sejam elas vitalistas, como a homeopatia, a oligoterapia catalítica de Menitrier, nutrição, aromaterapia, a Medicina Tradicional Chinesa (MTC), com seus tipos Yin e Yang, simpato e parassimpatomimético, respectivamente, bem como o tratamento alopático. A área psi é muito contemplada e poder-se-á entender e compreender que as doenças têm caminhos de mão dupla, isso é, sejam psicossomáticas e somatopsíquicas simultaneamente. O entendimento desse maestro chamado SNA é de vital importância para melhor compreender e entender o Homo Sapiens Sapiens e o mundo veterinário. O autor, ciente de que essa obra está longe de esgotar o assunto, aguarda críticas e sugestões para compor o seu principal desiderato, que é a saúde e bem-estar do ser vivente do planeta.

A systematic review of the effects of transcranial photobiomodulation on brain activity in humans.

In recent years, transcranial photobiomodulation (tPBM) has been developing as a promising method to protect and repair brain tissues against damages. The aim of our systematic review is to examine the results available in the literature concerning the efficacy of tPBM in changing brain activity in humans, either in healthy individuals, or in patients with neurological diseases. Four databases were screened for references containing terms encompassing photobiomodulation, brain activity, brain imaging, and human. We also analysed the quality of the included studies using validated tools. Results in healthy subjects showed that even after a single session, tPBM can be effective in influencing brain activity. In particular, the different transcranial approaches - using a focal stimulation or helmet for global brain stimulation - seemed to act at both the vascular level by increasing regional cerebral blood flow (rCBF) and at the neural level by changing the activity of the neurons. In addition, studies also showed that even a focal stimulation was sufficient to induce a global change in functional connectivity across brain networks. Results in patients with neurological disease were sparser; nevertheless, they indicated that tPBM could improve rCBF and functional connectivity in several regions. Our systematic review also highlighted the heterogeneity in the methods and results generated, together with the need for more randomised controlled trials in patients with neurological diseases. In summary, tPBM could be a promising method to act on brain function, but more consistency is needed in order appreciate fully the underlying mechanisms and the precise outcomes.

The Neurophysiology Behind Trauma-Focused Therapy Modalities Used to Treat Post-Traumatic Stress Disorder Across the Life Course: A Systematic Review.

This review presents the current state of understanding of trauma-informed modalities in light of current research in neuroscience, analyzing which brain structures and processes are impacted by these modalities. Studies included in the present review met the inclusion criteria of 1) addressing post-traumatic stress disorder (PTSD) in a specific population, 2) treatment of PTSD using any of the evidence-based trauma-informed modalities considered in this review, and 3) presenting functional magnetic resonance imagery (fMRI) data, derived from BOLD signals and voxel-compression maps, of brain structures impacted by these trauma-informed modalities. Articles for this review were collated through PubMed and MEDLINE, using key terms in descending order, such as 'childhood trauma', 'adolescent trauma', and 'adulthood trauma', to 'PTSD', 'fMRI', and so on, depending on the modality in question. Based on these criteria and research methods, 37 studies remained for inclusion in the present review. Among a number of critical findings, this review demonstrates that eye movement desensitization and reprocessing (EMDR) and mindfulness therapy effectively deactivate hindbrain regions implicated in the downregulation of autonomic nervous system (ANS) hyperarousal. This review also shows that trauma-focused cognitive behavioral therapy (TF-CBT) and EMDR activate the hippocampus, anterior cingulate cortex (ACC), medial prefrontal cortex (mPFC), and orbitofrontal cortex (OFC)-areas that are implicated in crucial cognitive, affective, and behavioral processes that aid trauma survivors in navigating their challenges.

The exciting side of unconventional glycine receptors.

In this issue of Neuron, Bossi, Dhanasobhon, and colleagues uncover the functional relevance of GluN1/GluN3A excitatory glycine receptors (eGlyRs) in the neocortex and amygdala. This study provides exciting new insights into the role of unconventional eGlyRs in brain function.

The effect of learning to drum on behavior and brain function in autistic adolescents.

This current study aimed to investigate the impact of drum training on behavior and brain function in autistic adolescents with no prior drumming experience. Thirty-six autistic adolescents were recruited and randomly assigned to one of two groups. The drum group received individual drum tuition (two lessons per week over an 8-wk period), while the control group did not. All participants attended a testing session before and after the 8-wk period. Each session included a drumming assessment, an MRI scan, and a parent completing questionnaires relating to the participants' behavioral difficulties. Results showed that improvements in drumming performance were associated with a significant reduction in hyperactivity and inattention difficulties in drummers compared to controls. The fMRI results demonstrated increased functional connectivity in brain areas responsible for inhibitory control, action outcomes monitoring, and self-regulation. In particular, seed-to-voxel analyses revealed an increased functional connectivity in the right inferior frontal gyrus and the right dorsolateral prefrontal cortex. A multivariate pattern analysis demonstrated significant changes in the medial frontal cortex, the left and right paracingulate cortex, the subcallosal cortex, the left frontal pole, the caudate, and the left nucleus accumbens. In conclusion, this study investigates the impact of a drum-based intervention on neural and behavioral outcomes in autistic adolescents. We hope that these findings will inform further research and trials into the potential use of drum-based interventions in benefitting clinical populations with inhibition-related disorders and emotional and behavioral difficulties.

Effects of Creatine Supplementation on Brain Function and Health.

While the vast majority of research involving creatine supplementation has focused on skeletal muscle, there is a small body of accumulating research that has focused on creatine and the brain. Preliminary studies indicate that creatine supplementation (and guanidinoacetic acid; GAA) has the ability to increase brain creatine content in humans. Furthermore, creatine has shown some promise for attenuating symptoms of concussion, mild traumatic brain injury and depression but its effect on neurodegenerative diseases appears to be lacking. The purpose of this narrative review is to summarize the current body of research pertaining to creatine supplementation on total creatine and phophorylcreatine (PCr) content, explore GAA as an alternative or adjunct to creatine supplementation on brain creatine uptake, assess the impact of creatine on cognition with a focus on sleep deprivation, discuss the effects of creatine supplementation on a variety of neurological and mental health conditions, and outline recent advances on creatine supplementation as a neuroprotective supplement following traumatic brain injury or concussion.

A comparison of directed functional connectivity among fist-related brain activities during movement imagery, movement execution, and movement observation.

Brain-computer interface (BCI) has been widely used in sports training and rehabilitation training. It is primarily based on action simulation, including movement imagery (MI) and movement observation (MO). However, the development of BCI technology is limited due to the challenge of getting an in-depth understanding of brain networks involved in MI, MO, and movement execution (ME). To better understand the brain activity changes and the communications across various brain regions under MO, ME, and MI, this study conducted the fist experiment under MO, ME, and MI. We recorded 64-channel electroencephalography (EEG) from 39 healthy subjects (25 males, 14 females, all right-handed) during fist tasks, obtained intensities and locations of sources using EEG source imaging (ESI), computed source activation modes, and finally investigated the brain networks using spectral Granger causality (GC). The brain regions involved in the three motor conditions are similar, but the degree of participation of each brain region and the network connections among the brain regions are different. MO, ME, and MI did not recruit shared brain connectivity networks. In addition, both source activation modes and brain network connectivity had lateralization advantages.

Aphantasia: The science of visual imagery extremes.

Visual imagery allows us to revisit the appearance of things in their absence and to test out virtual combinations of sensory experience. Visual imagery has been linked to many cognitive processes, such as autobiographical and visual working memory. Imagery also plays symptomatic and mechanistic roles in neurologic and mental disorders and is utilized in treatment. A large network of brain activity spanning frontal, parietal, temporal, and visual cortex is involved in generating and maintain images in mind. The ability to visualize has extreme variations, ranging from completely absent (aphantasia) to photo-like (hyperphantasia). The anatomy and functionality of visual cortex, including primary visual cortex, have been associated with individual differences in visual imagery ability, pointing to a potential correlate for both aphantasia and hyperphantasia. Preliminary evidence suggests that lifelong aphantasia is associated with prosopagnosia and reduction in autobiographical memory; hyperphantasia is associated with synesthesia. Aphantasic individuals can also be highly imaginative and are able to complete many tasks that were previously thought to rely on visual imagery, demonstrating that visualization is only one of many ways of representing things in their absence. The study of extreme imagination reminds us how easily invisible differences can escape detection.

Interesterified fat consumption since gestation decreases striatal dopaminergic targets levels and gdnf impairing locomotion of adult offspring.

Interesterified fat (IF) currently substitutes the hydrogenated vegetable fat (HVF) in processed foods. However, the IF consumption impact on the central nervous system (CNS) has been poorly studied. The current study investigated connections between IF chronic consumption and locomotor impairments in early life period and adulthood of rats and access brain molecular targets related to behavior changes in adulthood offspring. During pregnancy and lactation, female rats received soybean oil (SO) or IF and their male pups received the same maternal supplementation from weaning until adulthood. Pups' motor ability and locomotor activity in adulthood were evaluated. In the adult offspring striatum, dopaminergic targets, glial cell line-derived neurotrophic factor (GDFN) and lipid profile were quantified. Pups from IF supplementation group presented impaired learning concerning complex motor skill and sensorimotor behavior. The same animals showed decreased locomotion in adulthood. Moreover, IF group showed decreased immunoreactivity of all dopaminergic targets evaluated and GDNF, along with important changes in FA composition in striatum. This study shows that the brain modifications induce by IF consumption resulted in impaired motor control in pups and decreased locomotion in adult animals. Other studies about health damages induced by IF consumption may have a contribution from our current outcomes.

Children and adolescents' neural response to emotional faces and voices: Age-related changes in common regions of activation.

The perception of facial and vocal emotional expressions engages overlapping regions of the brain. However, at a behavioral level, the ability to recognize the intended emotion in both types of nonverbal cues follows a divergent developmental trajectory throughout childhood and adolescence. The current study a) identified regions of common neural activation to facial and vocal stimuli in 8- to 19-year-old typically-developing adolescents, and b) examined age-related changes in blood-oxygen-level dependent (BOLD) response within these areas. Both modalities elicited activation in an overlapping network of subcortical regions (insula, thalamus, dorsal striatum), visual-motor association areas, prefrontal regions (inferior frontal cortex, dorsomedial prefrontal cortex), and the right superior temporal gyrus. Within these regions, increased age was associated with greater frontal activation to voices, but not faces. Results suggest that processing facial and vocal stimuli elicits activation in common areas of the brain in adolescents, but that age-related changes in response within these regions may vary by modality.

Nesfatin-1 in the neurochemistry of eating disorders. / Nesfatyna-1 w neurochemii zaburzen odzywiania.

The vast majority of new neuropeptides feature unique biochemical properties as well as awide spectrum of physiological activity applied in numerous neuronal pathways, including hypothalamus and the limbic system. Special interest should be paid to nesfatin-1 - the relatively recently discovered and still intensively studied regulatory factor and a potential modulator of eating behaviors. New information about it now allows to consider this neuropeptide as a potentially important factor involved in the pathogenesis of many different mental disorders. The considered pharmacomodulation of nesfatinergic signaling may be potentially helpful in the future treatment of some neuropsychiatric and metabolic disorders including anorexia nervosa. Although the results of some basic and clinical tests seem to be promising, all possible applications of the aforementioned neuropeptides, together with their agonists and antagonists still remain in the area of speculation. The intensive search of selective modulators of their known receptors may facilitate the opening of a promising chapter in the eating disorders therapy. This paper provides a review of recent scientific reports regarding the hypothetical role of nesfatin-1 in the neuronal pathways related to pathophysiology of anorexia nervosa.

Rapid Effects of Selection on Brain-wide Activity and Behavior.

Interindividual variation in behavior and brain activity is universal and provides substrates for natural selection [1-9]. Selective pressures shift the expression of behavioral traits at the population level [10, 11], but the accompanying changes of the underlying neural circuitry have rarely been identified [12, 13]. Selection likely acts through the genetic and/or epigenetic underpinnings of neural activity controlling the selected behavior [14]. Endocrine and neuromodulatory systems participate in behavioral diversity and could provide the substrate for evolutionary modifications [15-21]. Here, we examined brain-wide patterns of activity in larval zebrafish selectively bred over two generations for extreme differences in habituation of the acoustic startle response (ASR) [22]. The ASR is an evolutionarily conserved defensive behavior induced by strong acoustic/vibrational stimuli. ASR habituation shows great individual variability that is stable over days and heritable [4, 22]. Selection for high ASR habituation leads to stronger sound-evoked activation of ASR-processing brain areas. In contrast, animals selected for low habituation displayed stronger spontaneous activity in ASR-processing centers. Ablation of dopaminergic tyrosine hydroxylase (TH) neurons decreased ASR sensitivity. Independently selected ASR habituation lineages link the effect of behavioral selection to dopaminergic caudal hypothalamus (HC) neurons [23]. High ASR habituation co-segregated with decreased spontaneous swimming phenotypes, but visual startle responses were unaffected. Furthermore, high- and low-habituation larvae differed in stress responses as adults. Thus, selective pressure over a couple of generations on ASR habituation behavior is able to induce substantial differences in brain activity, carrying along additional behaviors as piggyback traits that might further affect fitness in the wild. VIDEO ABSTRACT.

Efficacy of low-cost wireless neurofeedback to modulate brain activity during motor imagery.

OBJECTIVES: Motor imagery can be used as an adjunct to traditional stroke rehabilitation therapies for individuals who have hand and arm impairment resulting from their stroke. The provision of neurofeedback during motor imagery allows individuals to receive real time information regarding their motor imagery-related brain activity. However, the equipment required to administer this feedback is expensive and largely inaccessible to many of the individuals who could benefit from it. Available EEG-based technology provides an accessible, low-cost, wireless alternative to traditional neurofeedback methods, with the tradeoff of lower gain and channel count resulting in reduced signal quality. This study investigated the efficacy of this wireless technology for the provision of motor imagery-related neurofeedback. APPROACH: Twenty-eight healthy individuals participated in a 2-group, double-blinded study which involved imagining performing a unimanual button pressing task while receiving neurofeedback that is either a direct transform of their motor imagery-related brain activity (i.e., real) or is related to someone else's brain activity (i.e., sham). The change in amplitude of 15-30 Hz (beta) rhythmic brain activity elicited during the task blocks was calculated and analyzed across sessions and groups. MAIN RESULTS: We found that individuals who received real neurofeedback showed a statistically significant positive trajectory in modulating the amplitude of the beta rhythm across sessions, while those who received sham feedback showed a negative trajectory. Our results did not indicate a trend of increased lateralization across sessions, as has been shown in previous studies. SIGNIFICANCE: Our main findings replicated previous results with research-grade equipment indicating that there is potential for introducing this wireless technology for the provision of neurofeedback. Given the marginal longitudinal effect of neurofeedback in our study, further study is required to address the limitations associated with this technology before our protocol can be implemented in a clinical setting.

Neurophysiological, cognitive-behavioral and neurochemical effects in practitioners of transcendental meditation - A literature review.

The term meditation can be used in many different ways, according to the technique to which it refers. Transcendental Meditation (MT) is one of these techniques. TM could serve as a model for research on spiritual meditation, unlike the meditation techniques based on secular knowledge. The purpose of the present study is to conduct a bibliographic review to organize scientific evidence on the effects of TM on neurophysiology, neurochemistry, and cognitive and behavioral aspects of its practitioners. To conduct this critical narrative review of the literature, we searched for scientific papers on the PubMed database of the National Center for Biotechnology Information. The keywords used in the search were Transcendental Meditation, Neuroscience of meditation e Meditation and behavior. We selected 21 papers that analyzed different aspects that could be altered through meditation practice. We concluded that TM has positive and significant documentable neurochemical, neurophysiological, and cognitive-behavioral effects. Among the main effects are the reduction of anxiety and stress (due to the reduction of cortisol and norepinephrine levels), increase of the feeling of pleasure and well-being (due to the increase of the synthesis and release of dopamine and serotonin), and influence on memory recall and possible consolidation. Further studies are needed using creative and innovative methodological designs that analyze different neural circuitry and verify the clinical impact on practitioners.

Engineering brain activity patterns by neuromodulator polytherapy for treatment of disorders.

Conventional drug screens and treatments often ignore the underlying complexity of brain network dysfunctions, resulting in suboptimal outcomes. Here we ask whether we can correct abnormal functional connectivity of the entire brain by identifying and combining multiple neuromodulators that perturb connectivity in complementary ways. Our approach avoids the combinatorial complexity of screening all drug combinations. We develop a high-speed platform capable of imaging more than 15000 neurons in 50ms to map the entire brain functional connectivity in large numbers of vertebrates under many conditions. Screening a panel of drugs in a zebrafish model of human Dravet syndrome, we show that even drugs with related mechanisms of action can modulate functional connectivity in significantly different ways. By clustering connectivity fingerprints, we algorithmically select small subsets of complementary drugs and rapidly identify combinations that are significantly more effective at correcting abnormal networks and reducing spontaneous seizures than monotherapies, while minimizing behavioral side effects. Even at low concentrations, our polytherapy performs superior to individual drugs even at highest tolerated concentrations.

Neurophysiological, cognitive-behavioral and neurochemical effects in practitioners of transcendental meditation - A literature review

SUMMARY The term meditation can be used in many different ways, according to the technique to which it refers. Transcendental Meditation (MT) is one of these techniques. TM could serve as a model for research on spiritual meditation, unlike the meditation techniques based on secular knowledge. The purpose of the present study is to conduct a bibliographic review to organize scientific evidence on the effects of TM on neurophysiology, neurochemistry, and cognitive and behavioral aspects of its practitioners. To conduct this critical narrative review of the literature, we searched for scientific papers on the PubMed database of the National Center for Biotechnology Information. The keywords used in the search were Transcendental Meditation, Neuroscience of meditation e Meditation and behavior. We selected 21 papers that analyzed different aspects that could be altered through meditation practice. We concluded that TM has positive and significant documentable neurochemical, neurophysiological, and cognitive-behavioral effects. Among the main effects are the reduction of anxiety and stress (due to the reduction of cortisol and norepinephrine levels), increase of the feeling of pleasure and well-being (due to the increase of the synthesis and release of dopamine and serotonin), and influence on memory recall and possible consolidation. Further studies are needed using creative and innovative methodological designs that analyze different neural circuitry and verify the clinical impact on practitioners.

RESUMO O termo meditação pode ser utilizado de diversas formas, de acordo com a técnica a que se refere. A meditação transcendental (MT) é uma dessas técnicas meditativas. A MT pode ser um modelo para pesquisas de meditação espiritual, diferentemente de técnicas de meditação baseadas em uma compreensão secular. O presente estudo objetiva realizar uma revisão bibliográfica para organizar as evidências científicas sobre os efeitos da MT sobre a neurofisiologia, neuroquímica e aspectos cognitivos e comportamentais dos seus praticantes. Para a realização desta revisão narrativa crítica da literatura, foi realizado um levantamento dos artigos científicos presentes na base de dados PubMed do National Center for Biotechnology Information. As palavras-chave utilizadas na busca foram Transcendental Meditation, Neuroscience of meditation e Meditation and behavior. Foram selecionados 21 artigos que analisavam diferentes aspectos que poderiam ser alterados pela prática meditativa. Conclui-se que a MT produz efeitos neuroquímicos, neurofisiológicos e cognitivo-comportamentais documentáveis em seus praticantes, de caráter positivo e significativo. Entre os principais efeitos estão a diminuição da ansiedade e do estresse (via diminuição nos níveis de cortisol e noradrenalina), aumento na sensação de prazer e bem-estar (em decorrência ao aumento na síntese e liberação de dopamina e serotonina) e influência na evocação e possível consolidação da memória. São necessários mais estudos utilizando desenhos metodológicos inovadores e criativos, analisando diferentes circuitos neurais e verificando o impacto clínico sobre os praticantes.

Shared Neural Mechanisms of Visual Perception and Imagery.

For decades, the extent to which visual imagery relies on the same neural mechanisms as visual perception has been a topic of debate. Here, we review recent neuroimaging studies comparing these two forms of visual experience. Their results suggest that there is a large overlap in neural processing during perception and imagery: neural representations of imagined and perceived stimuli are similar in the visual, parietal, and frontal cortex. Furthermore, perception and imagery seem to rely on similar top-down connectivity. The most prominent difference is the absence of bottom-up processing during imagery. These findings fit well with the idea that imagery and perception rely on similar emulation or prediction processes.

[Effects of vertical water immersion on the nervous system: a systematic review]. / Efectos de la inmersion vertical en el agua sobre el sistema nervioso: revision sistematica.

INTRODUCTION: Vertical immersion induces a variety of physiological responses in different body systems, depending on the properties of fluid mechanics, which are the basis that underpins aquatic therapy programs in different pathologies. AIM: To perform a systematic review to analyze and describe the effects that vertical immersion produces on the nervous system in healthy subjects. SUBJECTS AND METHODS: A systematic search of the existing literature was conducted in the databases BRAIN, PubMed, PEDro and Web of Science. Quality was methodologically assessed using the CASPe guideline and the level of evidence was categorized using the Oxford scale. A total of 12 articles were included, with a score range of 7-10 according to CASPe, levels of evidence 1b-2b and grade of recommendation B. RESULTS: All studies showed positive results to the different forms of exposure of vertical immersion in water and the summation of the stimuli used; no adverse effects were reported in any case. CONCLUSIONS: The vertical immersion in the water generates positive effects on cerebral blood flows, cortical activation, executive functions and the production of neurotrophins in healthy subjects.

TITLE: Efectos de la inmersion vertical en el agua sobre el sistema nervioso: revision sistematica.Introduccion. La inmersion vertical induce una variedad de respuestas fisiologicas en diferentes sistemas corporales, dependiendo de las propiedades de la mecanica de fluidos, las cuales son la base que sustenta los programas de terapia acuatica en diferentes patologias. Objetivo. Realizar una revision sistematica para analizar y describir los efectos que la inmersion vertical produce en el sistema nervioso en sujetos sanos. Sujetos y metodos. Se llevo a cabo una busqueda sistematica de la bibliografia existente en las bases de datos BRAIN, PubMed, PEDro y Web of Science. Se evaluo metodologicamente la calidad mediante la guia CASPe y el nivel de evidencia se categorizo mediante la escala Oxford. Se incluyo un total de 12 articulos, con un rango de puntuacion de 7-10 segun CASPe, niveles de evidencia 1b-2b y grado de recomendacion B. Resultados. Todos los estudios mostraron resultados positivos a las diferentes formas de exposicion de la inmersion vertical en el agua y a la suma de estimulos empleados, sin referir efectos adversos en ningun caso. Conclusiones. La inmersion vertical en el agua genera efectos positivos sobre los flujos circulatorios cerebrales, la activacion cortical, las funciones ejecutivas y la produccion de neurotrofinas en sujetos sanos.