Women with abuse-related PTSD sleep more fitfully but just as long as healthy controls: an actigraphic study

Study Objectives Subjective reports of sleep impairments are common in individuals with posttraumatic stress disorder (PTSD), but objective assessments of sleep have yielded mixed results. Methods We investigated sleep via actigraphy and e-diary on 6 consecutive nights in a group of 117 women with PTSD after childhood abuse (CA; PTSD group), a group of 31 mentally healthy women with a history of CA (healthy trauma controls, HTC group) and a group of 36 non-traumatized mentally healthy women (healthy controls, HC group). Results The PTSD group reported lower sleep quality, more nights with nightmares, and shorter sleep duration than both HTC and HC. Actigraphic measures showed more and longer sleep interruptions in the PTSD group compared to HTC and HC, but no difference in sleep duration. While the PTSD group underestimated their sleep duration, both HTC and HC overestimated their sleep duration. HTC did not differ from HC regarding sleep impairments. Conclusions Sleep in women with PTSD after CA seems to be more fragmented but not shorter compared to sleep patterns of mentally healthy control subjects. The results suggest a stronger effect of PTSD psychopathology on sleep compared to the effect of trauma per se.

Oxytocin modulates neural reactivity in women to emotional stimuli of children depending on childhood emotional neglect

Sensitivity for rewarding cues and distress signals from children are fundamental to human caregiving, and modulated by the neuropeptide oxytocin. In a functional magnetic resonance imaging (fMRI) study we investigated whether oxytocin regulates neural responses to reward or distress cues form children. In a placebo controlled within-subject design we measured neural responses to positive, negative and neutral cues from children in 22 healthy female subjects who received oxytocin (24 IU) vs. placebo. Further, based on current literature, we hypothesized that oxytocin effects are modulated by experiences of childhood trauma. The task elicited valence specific effects, positive images activated the ventromedial prefrontal cortex, left anterior cingulate cortex and right putamen, and images of children in distress the bilateral amygdala, hippocampus and right medial superior frontal cortex. The effects of oxytocin depended on subjective reports of childhood emotional neglect. Self-reported neglect interacted with oxytocin administration in the amygdala, hippocampus and prefrontal areas. In individuals with higher scores of emotional neglect, oxytocin increased neural reactivity of limbic structures to positive and neutral images. Our findings need replication in larger samples but are in line with the recent literature on the modulating effect of childhood adversity on the sensitivity to OXT administration.

Visual Experiences without Presentational Phenomenology

A number of philosophers claim that visual experiences have a peculiar phenomenal character that is “presentational”. According to what I call the “Visual Presentationality Thesis”, this peculiar phenomenal character, presentational phenomenology, is not merely a contingent feature but is a necessary feature of visual experiences. Necessarily, visual experiences have presentational phenomenology. The main aim of this paper is to argue against the Visual Presentationality Thesis. I refute the Visual Presentationality Thesis by giving some counterexamples to it. In particular, I give counterexamples from derealization, which is a psychopathological condition that is characterized by the subjective impression of unreality or detachment from one’s surroundings. Derealization is a condition in which patients have visual experiences without presentational phenomenology. I defend this hypothesis about derealization on the basis of an inference to the best explanation; this hypothesis provides the best explanation of (otherwise puzzling) subjective reports by patients with derealization.

The Effect of Phasic Versus Combined Neuromuscular Electrical Stimulation Using the StimaWELL 120MTRS System on Multifidus Muscle Morphology and Function in Patients with Chronic Low Back Pain: A Randomized Pilot Control Trial Protocol

BackgroundNeuromuscular electrical stimulation (NMES) is used to improve muscle strength clinically when rehabilitating various musculoskeletal disorders. However, the effects of NMES on muscle morphology and function in individuals with non-specific chronic low back pain (CLBP) have scarcely been investigated. Although research links deficits in the paraspinal musculature with subjective reports of pain and disability, it is unknown if treatment with NMES can help reverse these deficits. Therefore, the primary aim of this study is to compare the effects of two muscle therapy protocols with a medium-frequency electrotherapy device (the StimaWELL 120MTRS system) on multifidus muscle morphology in CLBP patients. The secondary aims are to determine the effects of these protocols on multifidus muscle function, as well as subjective reports of pain intensity, pain interference, disability, and catastrophizing. MethodsA total of 30 participants with non-specific CLBP, aged 18-60, will be recruited from local orthopedic clinics and databases. Participants will be randomized (1:1) to either the phasic or combined (phasic + tonic) muscle therapy protocols on the StimaWELL 120MTRS system. Participants will undergo 20 supervised electrotherapy treatments over a 10-week period. The primary outcomes will be multifidus cross-sectional area (CSA) and fat infiltration. Secondary outcomes will include multifidus contraction (measured via %thickness change from a rested to contracted state), multifidus stiffness (at rest, and during contraction), as well as pain intensity, interference, disability, and catastrophizing. Both primary and secondary outcomes will be obtained at baseline and at 11-weeks; secondary outcomes measured via questionnaires will also be obtained at 6-weeks, while low back pain intensity will be measured before and after each treatment. Paired t-tests will be used to assess within-group changes for all primary outcome measures. A two-way repeated-measures analysis of variance will be use to assess changes in secondary outcomes over time. DiscussionThe results of this trial will help clarify the role of medium-frequency NMES on lumbar multifidus morphology and function. Trial RegistrationNCT04891692 Trial SponsorConcordia University, Montreal, Quebec, Canada

Effects of Moderate-to-Vigorous Acute Exercise on Visual Consciousness

Background the effect of acute exercise on cognition covers almost all stages of information processing, but few studies have focused on visual awareness. Subjective reports on the appearance of faint speed-changes in the perception of stimuli were used as an index for visual consciousness. Visual consciousness was assessed after exercise or rest. Aside from subjective index, objective speed-change discrimination was added as an index for the level of consciousness. Results: the results showed that subjective reports on the appearance of faint speed-changes in the perception of stimuli were affected by acute aerobic exercise. The hit rate for speed-change detection was marginally significantly higher after exercise than sedentary condition. Furthermore, the d’ index was higher after exercise. Analysis of the results obtained for the objective discrimination task showed that discrimination speed was boosted only when subjects were aware of the speed-change. Conclusions: these results suggest that acute exercise enhances visual consciousness.

How feelings of unpleasantness develop during the progression of motion sickness symptoms

To mitigate motion sickness in self-driving cars and virtual reality, one should be able to quantify its progression unambiguously. Self-report rating scales either focus on general feelings of unpleasantness or specific symptomatology. Although one generally feels worse as symptoms progress, there is anecdotal evidence suggesting a non-monotonic relationship between unpleasantness and symptomatology. This implies that individuals could (temporarily) feel better as symptoms progress, which could trouble an unambiguous measurement of motion sickness progression. Here we explicitly investigated the temporal development of both unpleasantness and symptomatology using subjective reports, as well as their mutual dependence using psychophysical scaling techniques. We found symptoms to manifest in a fixed order, while unpleasantness increased non-monotonically. Later manifesting symptoms were generally judged as more unpleasant, except for a reduction at the onset of nausea, which corresponded to feeling better. Although we cannot explicate the origin of this reduction, its existence is of importance to the quantification of motion sickness. Specifically, the reduction at nausea onset implies that rating how bad someone feels does not give you an answer to the question of how close someone is to the point of vomiting. We conclude that unpleasantness can unambiguously be inferred from symptomatology, but an ambiguity exists when inferring symptomatology from unpleasantness. These results speak in favor of rating symptomatology when prioritizing an unambiguous quantification of motion sickness progression.

Experiences of Student Circus Arts Performers Undertaking a Shoulder Rehabilitation Program Via Telehealth Consultation During the COVID-19 Pandemic

OBJECTIVE: To explore the subjective experiences of student circus arts performers with atraumatic shoulder instability undertaking a 12-week shoulder rehabilitation program during the COVID-19 pandemic lockdown, in Melbourne, Australia. METHODS: Using a qualitative design, 14 circus arts students from the National Institute of Circus Arts (Australia) were individually interviewed via teleconsultation. All interviews were recorded, transcribed, and analysed using inductive thematic analysis. RESULTS: Five overarching themes were identified: (i) impact (physical and mental), (ii) opportunity, (iii) developing routine, (iv) client-therapist relationship, and (v) transformation. All participants reported positive physical changes to their shoulder including increases in strength, stability, range of motion, less pain, “clicking” and “clunking,” improved posture, muscle memory, as well as carry-over to functional circus activities. The pandemic’s mental impact varied across the cohort, with positive and negative experiences described in relation to cognitive, social, and affective factors. Most performers felt the pandemic provided an opportunity to focus on rehabilitation of their shoulder. The program effects were also underpinned by positive client-therapist relationships and a progressive transformation of learning where students gained knowledge of their condition, developed tools to manage their current shoulder impairment, and learned how to apply this new knowledge to future management of their condition. CONCLUSION: A shoulder exercise intervention delivered via teleconsultation during the COVID-19 pandemic resulted in subjective reports of positive physical changes to the participants’ shoulder health complaint. This was facilitated through client-physiotherapist relationships, providing structure during uncertain times, and by providing education to help in understanding their condition and its future management.

Investigating racing thoughts via ocular temporal windows: deficits in the control of automatic perceptual processes

Background Racing thoughts have been found in several states of bipolar disorder (BD), but also in healthy populations with subclinical mood alterations. The evaluation of racing thoughts relies on subjective reports, and objective measures are sparse. The current study aims at finding an objective neuropsychological equivalent of racing thoughts in a mixed group of BD patients and healthy controls by using a bistable perception paradigm. Method Eighty-three included participants formed three groups based on participants' levels of racing thoughts reported via the Racing and Crowded Thoughts Questionnaire. Participants reported reversals in their perception during viewing of the bistable Necker cube either spontaneously, while asked to focus on one interpretation of the cube, or while asked to accelerate perceptual reversals. The dynamics of perceptual alternations were studied both at a conscious level (with manual temporal windows reflecting perceptual reversals) and at a more automatic level (with ocular temporal windows derived from ocular fixations). Results The rate of windows was less modulated by attentional conditions in participants with racing thoughts, and most clearly so for ocular windows. The rate of ocular windows was especially high when participants with racing thoughts were asked to focus on one interpretation of the Necker cube and when they received these instructions for the first time. Conclusions Our results indicate that in subjects with racing thoughts automatic perceptual processes escape cognitive control mechanisms. Racing thoughts may involve not only conscious thought mechanisms but also more automatic processes.

A longitudinal analysis of COVID-19 lockdown stringency on sleep and resting heart rate measures across 20 countries

Lockdowns imposed to stem the spread of COVID-19 massively disrupted the daily routines of many worldwide, but studies to date have been mostly confined to observations within a limited number of countries, based on subjective reports and surveys from specific time periods during the pandemic. We investigated associations between lockdown stringency and objective sleep and resting-heart rate measures in ~ 113,000 users of a consumer sleep tracker across 20 countries from Jan to Jul 2020, compared to an equivalent period in 2019. With stricter lockdown measures, midsleep times were universally delayed, particularly on weekdays, while midsleep variability and resting heart rate declined. These shifts (midsleep: + 0.09 to + 0.58 h; midsleep variability: − 0.12 to − 0.26 h; resting heart rate: − 0.35 to − 2.08 bpm) correlated with the severity of lockdown across different countries (all Ps < 0.001) and highlight the graded influence of stringency lockdowns on human physiology.