EEG signature of near-death-like experiences during syncope-induced periods of unresponsiveness.

During fainting, disconnected consciousness may emerge in the form of dream-like experiences. Characterized by extra-ordinary and mystical features, these subjective experiences have been associated to near-death-like experiences (NDEs-like). We here aim to assess brain activity during syncope-induced disconnected consciousness by means of high-density EEG monitoring. Transient loss of consciousness and unresponsiveness were induced in 27 healthy volunteers through hyperventilation, orthostasis, and Valsalva maneuvers. Upon awakening, subjects were asked to report memories, if any. The Greyson NDE scale was used to evaluate the potential phenomenological content experienced during the syncope-induced periods of unresponsiveness. EEG source reconstruction assessed cortical activations during fainting, which were regressed out with subjective reports collected upon recovery of normal consciousness. We also conducted functional connectivity, graph-theoretic and complexity analyses. High quality high-density EEG data were obtained in 22 volunteers during syncope and unresponsiveness (lasting 22±8 s). NDE-like features (Greyson NDE scale total score ≥7/32) were apparent for eight volunteers and characterized by higher activity in delta, theta and beta2 bands in temporal and frontal regions. The richness of the NDE-like content was associated with delta, theta and beta2 bands cortical current densities, in temporal, parietal and frontal lobes, including insula, right temporoparietal junction, and cingulate cortex. Our analyses also revealed a higher complexity and that networks related to delta, theta, and beta2 bands were characterized by a higher overall connectivity paralleled by a higher segregation (i.e., local efficiency) and a higher integration (i.e., global efficiency) for the NDE-like group compared to the non-NDE-like group. Fainting-induced NDE-like episodes seem to be sustained by surges of neural activity representing promising markers of disconnected consciousness.

Report from a Tibetan Monastery: EEG neural correlates of concentrative and analytical meditation.

The positive effects of meditation on human wellbeing are indisputable, ranging from emotion regulation improvement to stress reduction and present-moment awareness enhancement. Changes in brain activity regulate and support these phenomena. However, the heterogeneity of meditation practices and their cultural background, as well as their poor categorization limit the generalization of results to all types of meditation. Here, we took advantage of a collaboration with the very singular and precious community of the Monks and Geshes of the Tibetan University of Sera-Jey in India to study the neural correlates of the two main types of meditation recognized in Tibetan Buddhism, namely concentrative and analytical meditation. Twenty-three meditators with different levels of expertise underwent to an ecological (i.e., within the monastery) EEG acquisition consisting of an analytical and/or concentrative meditation session at "their best," and with the only constraint of performing a 5-min-long baseline at the beginning of the session. Time-varying power-spectral-density estimates of each session were compared against the baseline (i.e., within session) and between conditions (i.e., analytical vs. concentrative). Our results showed that concentrative meditation elicited more numerous and marked changes in the EEG power compared to analytical meditation, and mainly in the form of an increase in the theta, alpha and beta frequency ranges. Moreover, the full immersion in the Monastery life allowed to share the results and discuss their interpretation with the best scholars of the Monastic University, ensuring the identification of the most expert meditators, as well as to highlight better the differences between the different types of meditation practiced by each of them.

Sense of Agency and Skills Learning in Virtual-Mediated Environment: A Systematic Review.

Agency is central to remote actions, and it may enhance skills learning due to a partial overlap between brain structures and networks, the promotion of confidence towards a telemanipulator, and the feeling of congruence of the motor choice to the motor plan. We systematically reviewed studies aiming to verify the role of agency in improving learning. Fifteen studies were selected from MEDLINE and Scopus®. When a mismatch is introduced between observed and performed actions, the decrease in agency and learning is proportional to the intensity of the mismatch, which is due to greater interference with the motor programming. Thanks to multisensory integration, agency and learning benefit both from sensory and performance feedback and from the timing of feedback based on control at the goal level or the perceptual-motor level. This work constitutes a bedrock for professional teleoperation settings (e.g., robotic surgery), with particular reference to the role of agency in performing complex tasks with remote control.

Human-like problem-solving abilities in large language models using ChatGPT.

Backgrounds: The field of Artificial Intelligence (AI) has seen a major shift in recent years due to the development of new Machine Learning (ML) models such as Generative Pre-trained Transformer (GPT). GPT has achieved previously unheard-of levels of accuracy in most computerized language processing tasks and their chat-based variations. Aim: The aim of this study was to investigate the problem-solving abilities of ChatGPT using two sets of verbal insight problems, with a known performance level established by a sample of human participants. Materials and methods: A total of 30 problems labeled as "practice problems" and "transfer problems" were administered to ChatGPT. ChatGPT's answers received a score of "0" for each incorrectly answered problem and a score of "1" for each correct response. The highest possible score for both the practice and transfer problems was 15 out of 15. The solution rate for each problem (based on a sample of 20 subjects) was used to assess and compare the performance of ChatGPT with that of human subjects. Results: The study highlighted that ChatGPT can be trained in out-of-the-box thinking and demonstrated potential in solving verbal insight problems. The global performance of ChatGPT equalled the most probable outcome for the human sample in both practice problems and transfer problems as well as upon their combination. Additionally, ChatGPT answer combinations were among the 5% of most probable outcomes for the human sample both when considering practice problems and pooled problem sets. These findings demonstrate that ChatGPT performance on both set of problems was in line with the mean rate of success of human subjects, indicating that it performed reasonably well. Conclusions: The use of transformer architecture and self-attention in ChatGPT may have helped to prioritize inputs while predicting, contributing to its potential in verbal insight problem-solving. ChatGPT has shown potential in solving insight problems, thus highlighting the importance of incorporating AI into psychological research. However, it is acknowledged that there are still open challenges. Indeed, further research is required to fully understand AI's capabilities and limitations in verbal problem-solving.

Altered Brain Connectivity and Network Topological Organization in a Non-ordinary State of Consciousness Induced by Hypnosis.

Hypnosis has been shown to be of clinical utility; however, its underlying neural mechanisms remain unclear. This study aims to investigate altered brain dynamics during the non-ordinary state of consciousness induced by hypnosis. We studied high-density EEG in 9 healthy participants during eyes-closed wakefulness and during hypnosis, induced by a muscle relaxation and eyes fixation procedure. Using hypotheses based on internal and external awareness brain networks, we assessed region-wise brain connectivity between six ROIs (right and left frontal, right and left parietal, upper and lower midline regions) at the scalp level and compared across conditions. Data-driven, graph-theory analyses were also carried out to characterize brain network topology in terms of brain network segregation and integration. During hypnosis, we observed (1) increased delta connectivity between left and right frontal, as well as between right frontal and parietal regions; (2) decreased connectivity for alpha (between right frontal and parietal and between upper and lower midline regions) and beta-2 bands (between upper midline and right frontal, frontal and parietal, also between upper and lower midline regions); and (3) increased network segregation (short-range connections) in delta and alpha bands, and increased integration (long-range connections) in beta-2 band. This higher network integration and segregation was measured bilaterally in frontal and right parietal electrodes, which were identified as central hub regions during hypnosis. This modified connectivity and increased network integration-segregation properties suggest a modification of the internal and external awareness brain networks that may reflect efficient cognitive-processing and lower incidences of mind-wandering during hypnosis.

Tinnitus and distress: an electroencephalography classification study.

There exist no objective markers for tinnitus or tinnitus disorders, which complicates diagnosis and treatments. The combination of EEG with sophisticated classification procedures may reveal biomarkers that can identify tinnitus and accurately differentiate different levels of distress experienced by patients. EEG recordings were obtained from 129 tinnitus patients and 142 healthy controls. Linear support vector machines were used to develop two classifiers: the first differentiated tinnitus patients from controls, while the second differentiated tinnitus patients with low and high distress levels. The classifier for healthy controls and tinnitus patients performed with an average accuracy of 96 and 94% for the training and test sets, respectively. For the distress classifier, these average accuracies were 89 and 84%. Minimal overlap was observed between the features of the two classifiers. EEG-derived features made it possible to accurately differentiate healthy controls and tinnitus patients as well as low and high distress tinnitus patients. The minimal overlap between the features of the two classifiers indicates that the source of distress in tinnitus, which could also be involved in distress related to other conditions, stems from different neuronal mechanisms compared to those causing the tinnitus pathology itself.

The Hidden Impact of Covid-19 on Memory: Disclosing Subjective Complaints.

Objective: A significant body of research has suggested that the contraction of SARS-CoV-2 may cause memory impairment, even in the months following recovery. In this regard, studies suggest that COVID-19 predominantly targets structures and cortices within the temporal lobe, and the hippocampus, a critical brain structure for memory and spatial navigation.The purpose of this study was to investigate the potential impact of the COVID-19 pandemic on subjective memory complaints, which represent an individual's perception of subtle changes in memory in the absence of an objective memory impairment. Method: to explore how the COVID-19 pandemic may affect subjective memory complaints, we incorporated ad hoc self-reported measures of subjective memory complaints, the "Subjective Memory Complaints Questionnaire" (SMCQ) and the "Prospective and Retrospective Memory Questionnaire" (PRMQ), in our cross-sectional study. Both measures referred to two periods: the pre-pandemic period (T0) and the moment of survey administration (T1) (December 28th, 2021, to February 6th, 2022). Results: 207 Italian participants accessed the survey, out of which 189 participants were included in the final sample. The majority of the participants were females, and their age ranged from 55 to 65 years. The study revealed a significant increase in the total PRMQ score at T1 compared to T0 (p = 0.02). However, no significant differences were found between PRMQ and SMCQ scores of COVID-19-negative individuals and those who tested positive for COVID-19 in the last 12 months from the date of completing the survey. McNemar's test showed a statistically significant increase in the score of item 1 ("Do you think that you have a memory problem?" (p = 0.016) and item 10 ("Do you lose objects more often than you did previously") (0.019) of the SMCQ, while for the PRMQ, significant increases were found in several individual items. Conclusions: our study suggests that subjective memory complaints increased during the pandemic, potentially due to the compound effects of stress and social isolation, rather than solely due to COVID-19 infection. Although a marginal association between COVID-19 and reported prospective memory issues was detected, further investigation is warranted to understand its persistent effects.

Neural Correlates of Non-ordinary States of Consciousness in Pranayama Practitioners: The Role of Slow Nasal Breathing.

The modulatory effect of nasal respiration on integrative brain functions and hence consciousness has recently been unambiguously demonstrated. This effect is sustained by the olfactory epithelium mechanical sensitivity complemented by the existence of massive projections between the olfactory bulb and the prefrontal cortex. However, studies on slow nasal breathing (SNB) in the context of contemplative practices have sustained the fundamental role of respiratory vagal stimulation, with little attention to the contribution of the olfactory epithelium mechanical stimulation. This study aims at disentangling the effects of olfactory epithelium stimulation (proper of nasal breathing) from those related to respiratory vagal stimulation (common to slow nasal and mouth breathing). We investigated the psychophysiological (cardio-respiratory and electroencephalographic parameters) and phenomenological (perceived state of consciousness) aftereffects of SNB (epithelium mechanical - 2.5 breaths/min) in 12 experienced meditators. We compared the nasal breathing aftereffects with those observed after a session of mouth breathing at the same respiratory rate and with those related to a resting state condition. SNB induced (1) slowing of electroencephalography (EEG) activities (delta-theta bands) in prefrontal regions, (2) a widespread increase of theta and high-beta connectivity complemented by an increase of phase-amplitude coupling between the two bands in prefrontal and posterior regions belonging to the Default Mode Network, (3) an increase of high-beta networks small-worldness. (4) a higher perception of being in a non-ordinary state of consciousness. The emerging scenario strongly suggests that the effects of SNB, beyond the relative contribution of vagal stimulation, are mainly ascribable to olfactory epithelium stimulation. In conclusion, slow Pranayama breathing modulates brain activity and hence subjective experience up to the point of inducing a non-ordinary state of consciousness.

The Consciousness State of Traditional Nidrâ Yoga/Modern Yoga Nidra: Phenomenological Characterization and Preliminary Insights from an EEG Study.

Nidrâ yoga is an ancient yogic practice capable of inducing altered states of consciousness characterized by deep relaxation, strong concentration, acute self-awareness, and joy. In modern contemplative neuroscience language, it is known by the name yoga nidra, and few studies have investigated its phenomenological and psychophysiological effects. Six healthy volunteers (four females aged 31-74) performed 12 yoga nidra sessions guided by an expert during a 6-day retreat. Each session consisted of 10 minutes in a resting state (baseline) followed by 2 hours of yoga nidra. Psychometric data regarding dissociative experiences (Clinician Administered Dissociative States Scale) and the state of consciousness (Phenomenology of Consciousness Inventory) were collected after baseline and yoga nidra, while high-density EEG was recorded during the entire session. During nidra sessions, no sleep hallmarks (i.e., K-complexes and sleep spindles) were detected by the EEG in any subject. Psychometric data we re analyzed using a Wilcoxon signed-rank test corrected with the false discovery rate approach for multiple comparisons. Compared to baseline, yoga nidra practice was related to: (1) increased dissociative effects (p = 0.022); (2) perception of being in an altered state of consciousness (p = 0.026); (3) alterations in perceived body image (p = 0.022); (4) increased "meaningfulness" attributed to the experience (p = 0.026); (5) reduced rational thinking (p = 0.029); and (6) reduced volitional thought control (p = 0.026). First-person experience is discussed in relation to descriptive EEG power spectral density analysis, which was performed in one subject because of severe EEG artifacts in the other recordings; that subject showed, compared to baseline: (1) early increase of alpha and beta power, followed by a progressive widespread reduction; (2) widespread early increase of theta power, followed by a progressive reduction; and (3) widespread increase of gamma power in the latest stages. The present preliminary results enrich the knowledge of yoga nidra, elucidating its phenomenology and suggesting some psychophysiological correlates that future studies may address.

High-Density EEG in a Charles Bonnet Syndrome Patient during and without Visual Hallucinations: A Case-Report Study.

Charles Bonnet syndrome (CBS) is a rare clinical condition characterized by complex visual hallucinations in people with loss of vision. So far, the neurobiological mechanisms underlying the hallucinations remain elusive. This case-report study aims at investigating electrical activity changes in a CBS patient during visual hallucinations, as compared to a resting-state period (without hallucinations). Prior to the EEG, the patient underwent neuropsychological, ophthalmologic, and neurological examinations. Spectral and connectivity, graph analyses and signal diversity were applied to high-density EEG data. Visual hallucinations (as compared to resting-state) were characterized by a significant reduction of power in the frontal areas, paralleled by an increase in the midline posterior regions in delta and theta bands and by an increase of alpha power in the occipital and midline posterior regions. We next observed a reduction of theta connectivity in the frontal and right posterior areas, which at a network level was complemented by a disruption of small-worldness (lower local and global efficiency) and by an increase of network modularity. Finally, we found a higher signal complexity especially when considering the frontal areas in the alpha band. The emergence of hallucinations may stem from these changes in the visual cortex and in core cortical regions encompassing both the default mode and the fronto-parietal attentional networks.

Mapping the functional brain state of a world champion freediver in static dry apnea.

Voluntary apnea showcases extreme human adaptability in trained individuals like professional free divers. We evaluated the psychological and physiological adaptation and the functional cerebral changes using electroencephalography (EEG) and functional Magnetic Resonance Imaging (fMRI) to 6.5 min of dry static apnea performed by a world champion free diver. Compared to resting state at baseline, breath holding was characterized by increased EEG power and functional connectivity in the alpha band, along with decreased delta band connectivity. fMRI connectivity was increased within the default mode network (DMN) and visual areas but decreased in pre- and postcentral cortices. While these changes occurred in regions overlapping with cerebral signatures of several meditation practices, they also display some unique features that suggest an altered somatosensory integration. As suggested by self-reports, these findings could reflect the ability of elite free divers to create a state of sensory dissociation when performing prolonged apnea.

Catastrophisation, chronic pain and sexuality: a cross-sectional investigation in fibromyalgia and rheumatoid arthritis.

OBJECTIVES: In the present study we investigate the putative differences in pain catastrophising (PC), pain perception (PP), sexual functioning (SF), satisfaction (SS), and overall quality of life between fibromyalgia (FM) and rheumatoid arthritis (RA) patients as compared to healthy controls (HC). METHODS: Fifty-seven native Italian-speaking female individuals suffering either from FM or RA and thirty-eight healthy female controls (FM = 40; RA = 17; HC = 38) were submitted to a semi-structured interview aimed at assessing PP intensity (Visual Analog Scale; VAS), general health conditions (36-items Short-Form Health Survey; SF-36), PC (Pain Catastrophising Scale; PCS), SF and SS (Index of Sexual Satisfaction; ISS/ Female Sexual Function Index; FSFI). RESULTS: FM patients had a significantly higher PP both as compared to RA and HC (p<0.002 for both), and higher PC as compared to HC but not as compared to RA patients (p<0.03 and p<0.64). When compared to RA patients and HC, they showed a lower quality of life (p<0.002 for both comparisons), a compromised SF (p<0.003 and p<0.002, respectively) and a lower index of SS with respect to HC (p<0.002). RA patients had higher PP (VAS; p<0.002), lower quality of life and SF as compared to HC (p<0.002 and p<0.003, respectively). CONCLUSIONS: FM and RA patients showed a significantly lower quality of life, SF and SS as compared to HC. PC was significantly related to PP and low quality of life in FM patients while in RA patients it negatively affected quality of life and especially the sexual sphere both when considering SF and SS.

A novel closed-loop EEG-tDCS approach to promote responsiveness of patients in minimally conscious state: A study protocol.

Transcranial direct current stimulation (tDCS) applied over the prefrontal cortex has been shown to improve behavioral responsiveness in patients with disorders of consciousness following severe brain injury, especially those in minimally conscious state (MCS). However, one potential barrier of clinical response to tDCS is the timing of stimulation with regard to the fluctuations of vigilance that characterize this population. Indeed, a previous study showed that the vigilance of MCS patients has periodic average cycles of 70 min (range 57-80 min), potentially preventing them to be in an optimal neural state to benefit from tDCS when applied randomly. To tackle this issue, we propose a new protocol to optimize the application of tDCS by selectively stimulating at high and low vigilance states. Electroencephalography (EEG) real-time spectral entropy will be used as a marker of vigilance and to trigger tDCS, in a closed-loop fashion. We will conduct a randomized controlled crossover clinical trial on 16 patients in prolonged MCS who will undergo three EEG-tDCS sessions 5 days apart (1. tDCS applied at high vigilance; 2. tDCS applied at low vigilance; 3. tDCS applied at a random moment). Behavioral effects will be assessed using the Coma Recovery Scale-Revised at baseline and right after the stimulations. EEG will be recorded throughout the session and for 30 min after the end of the stimulation. This unique and novel approach will provide patients' tailored treatment options, currently lacking in the field of disorders of consciousness.

Sleep slow oscillations favour local cortical plasticity underlying the consolidation of reinforced procedural learning in human sleep.

We investigated changes of slow-wave activity and sleep slow oscillations in the night following procedural learning boosted by reinforcement learning, and how these changes correlate with behavioural output. In the Task session, participants had to reach a visual target adapting cursor's movements to compensate an angular deviation introduced experimentally, while in the Control session no deviation was applied. The task was repeated at 13:00 hours, 17:00 hours and 23:00 hours before sleep, and at 08:00 hours after sleep. The deviation angle was set at 15° (13:00 hours and 17:00 hours) and increased to 45° (reinforcement) at 23:00 hours and 08:00 hours. Both for Task and Control nights, high-density electroencephalogram sleep recordings were carried out (23:30-19:30 hours). The Task night as compared with the Control night showed increases of: (a) slow-wave activity (absolute power) over the whole scalp; (b) slow-wave activity (relative power) in left centro-parietal areas; (c) sleep slow oscillations rate in sensorimotor and premotor areas; (d) amplitude of pre-down and up states in premotor regions, left sensorimotor and right parietal regions; (e) sigma crowning the up state in right parietal regions. After Task night, we found an improvement of task performance showing correlations with sleep slow oscillations rate in right premotor, sensorimotor and parietal regions. These findings suggest a key role of sleep slow oscillations in procedural memories consolidation. The diverse components of sleep slow oscillations selectively reflect the network activations related to the reinforced learning of a procedural visuomotor task. Indeed, areas specifically involved in the task stand out as those with a significant association between sleep slow oscillations rate and overnight improvement in task performance.

Local Gamma Activity During Non-REM Sleep in the Context of Sensory Evoked K-Complexes.

K-complexes (KCs) and Sleep Slow Oscillations (SSOs) are the EEG expression of neuronal bistability during deeper stages Non-REM sleep. They are characterized by a deep negative deflection lasting about half-a-second, sustained, at the cortical level, by a widespread and synchronized neuronal hyperpolarization (i.e., electrical silence). The phase of hyperpolarization is followed by a period of intense and synchronized neuronal firing (i.e., depolarization phase) resulting at the EEG level, in a large positive deflection (lasting about 0.5 s) and a concurrent high frequency activity (i.e., spindles). Both KCs and SSOs rather than being "local" phenomena, propagate over large sections of the cortex. These features suggest that bistability is a large-scale network phenomenon, possibly driven by a propagating excitatory activity and involving wide populations of synchronized neurons. We have recently shown that KCs and SSOs include a positive bump preceding the negative peak and that for sensory-evoked KCs this bump coincides with the P200 wave. We demonstrated that the P200 has a sensory-modality specific localization, as it is firstly elicited in the primary sensory areas related to the stimulus, which in turn receive projections from the thalamic core. We observed that the P200 acts as a propagating excitatory activity and hypothesized that it could play a key role in inducing the opening of K+ channels, and hence the cortical hyperpolarization. Here we demonstrate that the P200 is sustained by a high-frequency excitation bringing further support to its role in triggering bistability. We show that the P200 has a higher power density in gamma band as compared to the P900 coherently for all sensory modalities, and we confirm that the latter wave is crowned by higher activity in sigma-beta bands. Finally, we characterize the P200 gamma activity at the cortical level in terms of spatial localization and temporal dynamics, demonstrating that it emerges in sensory stimulus-specific primary areas and travels over the cortical mantle spreading toward fronto-central associative areas and fading concurrently with the N550 onset.

Effect of multichannel transcranial direct current stimulation to reduce hypertonia in individuals with prolonged disorders of consciousness: A randomized controlled pilot study.

BACKGROUND: Spasticity management in severely brain-injured patients with disorders of consciousness (DOC) is a major challenge because it leads to complications and severe pain that can seriously affect quality of life. OBJECTIVES: We aimed to determine the feasibility of a single session of transcranial direct current stimulations (tDCS) to reduce spasticity in chronic patients with DOC. METHODS: We enrolled 14 patients in this double-blind, sham-controlled randomized crossover pilot study. Two cathodes were placed over the left and right primary motor cortex and 2 anodes over the left and right prefrontal cortex. Hypertonia of the upper limbs and level of consciousness were assessed by the Modified Ashworth Scale (MAS) and the Coma Recovery Scale-Revised (CRS-R). Resting state electroencephalography was also performed. RESULTS: At the group level, spasticity was reduced in only finger flexors. Four responders (29%) showed reduced hypertonicity in at least 2 joints after active but not sham stimulation. We found no behavioural changes by the CRS-R total score. At the group level, connectivity values in beta2 were higher with active versus sham stimulation. Relative power in the theta band and connectivity in the beta band were higher for responders than non-responders after the active stimulation. CONCLUSION: This pilot study highlights the potential benefit of using tDCS for reducing upper-limb hypertonia in patients with chronic DOC. Large-sample clinical trials are needed to optimize and validate the technique.

Mindfulness dispositions and defense style as positive responses to psychological distress in oncology professionals.

PURPOSE: Working in oncology departments is a stressful and emotionally consuming experience and oncology professionals are particularly at risk for developing stress-related syndromes. Defense mechanisms (high-adaptive) and mindfulness dispositions are known as facilitators of well-being and adaptation. In this study we analysed the role of these unconscious and conscious strategies in protecting the oncology clinicians from stress-related symptoms. METHOD: A convenience sample of 63 oncology professionals was assessed on defense style, mindfulness disposition, depression and anxiety symptoms using self-reported questionnaires. Demographic and professional information was included in data collection. RESULTS: Results did not show significance differences in demographic and professional characteristics among all studied variables. Mature defense style and mindfulness were highly and negatively correlated with depression and anxiety, while a positive association was found between immature defense style and both depression and anxiety symptoms. Hierarchical multiple regression analyses found defense styles and mindfulness as predictors of depression, whereas only immature defense style predicted anxiety. CONCLUSIONS: The present study provides the first empirical evidence of the influence of unconscious defense mechanisms and conscious mindfulness dispositions in protecting oncology professionals from depression and anxiety symptoms. Defense mechanisms and mindfulness share several common-points and should be seen as complementary in enhancing physical and psychological well-being. Further studies are required for a deeper understanding of the impact of mindfulness and defenses in improving adaptation.

How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing.

Background: The psycho-physiological changes in brain-body interaction observed in most of meditative and relaxing practices rely on voluntary slowing down of breath frequency. However, the identification of mechanisms linking breath control to its psychophysiological effects is still under debate. This systematic review is aimed at unveiling psychophysiological mechanisms underlying slow breathing techniques (<10 breaths/minute) and their effects on healthy subjects. Methods: A systematic search of MEDLINE and SCOPUS databases, using keywords related to both breathing techniques and to their psychophysiological outcomes, focusing on cardio-respiratory and central nervous system, has been conducted. From a pool of 2,461 abstracts only 15 articles met eligibility criteria and were included in the review. The present systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: The main effects of slow breathing techniques cover autonomic and central nervous systems activities as well as the psychological status. Slow breathing techniques promote autonomic changes increasing Heart Rate Variability and Respiratory Sinus Arrhythmia paralleled by Central Nervous System (CNS) activity modifications. EEG studies show an increase in alpha and a decrease in theta power. Anatomically, the only available fMRI study highlights increased activity in cortical (e.g., prefrontal, motor, and parietal cortices) and subcortical (e.g., pons, thalamus, sub-parabrachial nucleus, periaqueductal gray, and hypothalamus) structures. Psychological/behavioral outputs related to the abovementioned changes are increased comfort, relaxation, pleasantness, vigor and alertness, and reduced symptoms of arousal, anxiety, depression, anger, and confusion. Conclusions: Slow breathing techniques act enhancing autonomic, cerebral and psychological flexibility in a scenario of mutual interactions: we found evidence of links between parasympathetic activity (increased HRV and LF power), CNS activities (increased EEG alpha power and decreased EEG theta power) related to emotional control and psychological well-being in healthy subjects. Our hypothesis considers two different mechanisms for explaining psychophysiological changes induced by voluntary control of slow breathing: one is related to a voluntary regulation of internal bodily states (enteroception), the other is associated to the role of mechanoceptors within the nasal vault in translating slow breathing in a modulation of olfactory bulb activity, which in turn tunes the activity of the entire cortical mantle.

EEG ultradian rhythmicity differences in disorders of consciousness during wakefulness.

Temporal fluctuations of cognitively-mediated behaviors in minimally conscious state (MCS) have been linked to changes of awareness, but the time-pattern of these variations remains ill-described. We analyzed 4-h EEG recordings from 12 patients with disorders of consciousness (6 MCS and 6 vegetative state/unresponsive wakefulness syndrome, VS/UWS). Relative powers (delta, theta, alpha, beta1 and beta2 bands) and spectral entropy were estimated (Fz, Cz and Pz derivations). Spectral entropy time-courses were then analyzed. MCS patients had higher theta and alpha and lower delta power when compared to VS/UWS. They showed higher spectral entropy mean value and higher time variability. MCS patients were characterized by spectral entropy fluctuations with periodicities of 70 min (range 57-80 min). Notably, these periodicities closely resemble those described in awake healthy subjects, which were hypothesized to be related to fluctuation in vigilance/attention. No significant periodicity was observed for VS/UWS. The spectral entropy periodicity found in MCS patients could reflect the fluctuation of awareness responsible for the inconsistency of MCS manifestation of cognitively-mediated behaviors. The presence of a 70 min periodicity in spectral entropy could permit clinicians to better choose their time-window when performing a clinical assessment of consciousness. It could also permit to monitor fluctuations in cognitive performance (i.e., response to command) during complementary testing by passive or active electrophysiological or functional neuroimaging paradigms or in resting state conditions.

Clinical Response to tDCS Depends on Residual Brain Metabolism and Grey Matter Integrity in Patients With Minimally Conscious State.

BACKGROUND: Transcranial direct current stimulation (tDCS) was recently shown to promote recovery of voluntary signs of consciousness in some patients in minimally conscious state (MCS). However, it remains unclear why clinical improvement is only observed in a subgroup of patients. OBJECTIVES: In this retrospective study, we investigated the relationship between tDCS responsiveness and neuroimaging data from MCS patients. METHODS: Structural Magnetic Resonance Imaging (MRI), Fluorodeoxyglucose Positron emission tomography (FDG-PET) and clinical electroencephalography (EEG) were acquired in 21 sub-acute and chronic MCS patients (8 tDCS responders) who subsequently (<48 h) received left dorsolateral prefrontal (DLPF) tDCS in a double-blind randomized cross-over trial. The behavioral data have been published elsewhere (Thibaut et al., Neurology, 2014). RESULTS: Grey matter atrophy was observed in non-responders as compared with responders in the left DLPF cortex, the medial-prefrontal cortex, the cingulate cortex, the hippocampi, part of the rolandic regions, and the left thalamus. FDG-PET showed hypometabolism in non-responders as compared with responders in the left DLPF cortex, the medial-prefrontal cortex, the precuneus, and the thalamus. EEG did not show any difference between the two groups. CONCLUSION: Our findings suggest that the transient increase of signs of consciousness following left DLPF tDCS in patients in MCS require grey matter preservation and residual metabolic activity in cortical and subcortical brain areas known to be involved in attention and working memory. These results further underline the critical role of long-range cortico-thalamic connections in consciousness recovery, providing important information for guidelines on the use of tDCS in disorders of consciousness.