Iniencephaly

Iniencephaly is an uncommon form of neural tube defects which is characterized by retroflexion of the head and absence of neck as a consequence of defective closure of the vertebral body and arch. Multiple identified risk factors for its causation include environmental, genetic and drugs. We report a case of 38-year-old woman with prior history of still birth and abortions who presented at 35 weeks of gestation with lower abdominal pain and high blood pressure. Mother had consanguineous marriage. Her hypothyroidism was untreated in the first and second trimester. She delivered an iniencephalic baby girl via emergency c-section with multiple malformations at 38 weeks gestation secondary to fetal cardiac deceleration. Baby survived for less than 18 hours. In this case, proper antenatal care and follow up visits were needed along with postnatal genetic and pathological evaluation including assessment of risk factors. Appropriate management is important to prevent complications and recurrence in subsequent pregnancies.

Awareness is required for autonomic performance monitoring in instrumental learning: Evidence from cardiac activity

Performance monitoring is a vital aspect of successful learning and decision-making. Performance errors are reflected in the autonomic nervous system, indicating the need for behavioural adjustment. As part of this response, errors cause a pronounced deceleration in heart rate, compared to correct decisions, and precede explicit awareness of the stimulus-outcome contingencies. However, it is unknown whether those signals are present and able to inform instrumental learning without conscious awareness of the stimuli, where explicit performance monitoring is disabled. With mixed evidence for unconscious instrumental learning, determining the presence or absence of autonomic performance monitoring can shed light on its feasibility.Here, we employed an unconscious instrumental conditioning task, where successful learning is evidenced by increased approach responses to visually masked rewarding stimuli, and avoidance of punishing stimuli. An electrocardiogram (ECG) assessed continuous cardiac activity throughout the learning process. Natural fluctuations of awareness under masking permitted us to contrast learning and cardiac deceleration for trials with, versus without, conscious stimulus awareness. Our results demonstrate that on trials where participants did not consciously perceive the stimulus, there was no differentiation in cardiac response between rewarding and punishing feedback, indicating absence of performance monitoring. In contrast, consciously perceived stimuli elicited the expected deceleration upon error commission. This result suggests that, in unconscious instrumental learning, the brain cannot acquire implicit knowledge of stimulus values, rendering correct instrumental choices impossible. This evidence provides support for the notion that consciousness might be required for flexible adaptive behaviour, and that this may be mediated through bodily signals.

Development of a Classical Conditioning Task for Humans Examining Phasic Heart Rate Responses to Signaled Appetitive Stimuli: A Pilot Study

Cardiac responses to appetitive stimuli have been studied as indices of motivational states and attentional processes, the former being associated with cardiac acceleration and latter deceleration. Very few studies have examined heart rate changes in appetitive classical conditioning in humans. The current study describes the development and pilot testing of a classical conditioning task to assess cardiac responses to appetitive stimuli and cues that reliably precede them. Data from 18 adults were examined. They were shown initially neutral visual stimuli (putative CS) on a computer screen followed by pictures of high-caloric food (US). Phasic cardiac deceleration to food images was observed, consistent with an orienting response to motivationally significant stimuli. Similar responses were observed to non-appetitive stimuli when they were preceded by the cue associated with the food images, suggesting that attentional processes were engaged by conditioned stimuli. These autonomic changes provide significant information about classical conditioning effects in humans.

Threat induces changes in cardiac activity and metabolism negatively impacting survival in flies

Adjusting to a dynamic environment involves fast changes in the body’s internal state, characterized by coordinated alterations in brain activity, physiological and motor responses. Threat-induced defensive states are a classic example of coordinated adjustment of bodily responses, being cardiac regulation one of the best characterized in vertebrates. A great deal is known regarding the neural basis of invertebrate defensive behaviours, mainly in Drosophila melanogaster. However, whether physiological changes accompany these remains unknown. Here, we set out to describe the internal bodily state of fruit flies upon an inescapable threat and found cardiac acceleration during running and deceleration during freezing. In addition, we found that freezing leads to increased cardiac pumping from the abdomen towards the head-thorax, suggesting mobilization of energy resources. Concordantly, threat-triggered freezing reduces sugar levels in the hemolymph and renders flies less resistant to starvation. The cardiac responses observed during freezing were absent during spontaneous immobility, underscoring the active nature of freezing response. Finally, we show that baseline cardiac activity predicts the amount of freezing upon threat. This work reveals a remarkable similarity with the cardiac responses of vertebrates, suggesting an evolutionarily convergent defensive state in flies. Our findings are at odds with the widespread view that cardiac deceleration while freezing has first evolved in vertebrates and that it is energy sparing. Investigating the physiological changes coupled to defensive behaviours in the fruit fly has revealed that freezing is costly, yet accompanied by cardiac deceleration, and points to heart activity as a key modulator of defensive behaviours.

Long-term modulation of cardiac activity induced by inhibitory control over emotional memories

Efforts to exclude past experiences from conscious awareness can lead to forgetting. Memory suppression is central to affective disorders, but we still do not really know whether emotions, including their physiological causes, are also impacted by this process in normal functioning individuals. In two studies, we measured the after-effects of suppressing negative memories on cardiac response in healthy participants. Results of Study 1 revealed that efficient control of memories was associated with long-term inhibition of the cardiac deceleration that is normally induced by disgusting stimuli. Attempts to suppress sad memories, by contrast, aggravated the cardiac response, an effect that was closely related to the inability to forget this specific material. In Study 2, electroencephalography revealed a reduction in power in the theta (3–8 Hz), alpha (8–12 Hz) and low-beta (13–20 Hz) bands during the suppression of unwanted memories, compared with their voluntary recall. Interestingly, however, the reduction of power in the theta frequency band during memory control was related to a subsequent inhibition of the cardiac response. These results provide a neurophysiological basis for the influence of memory control mechanisms on the cardiac system, opening up new avenues and questions for treating intrusive memories using motivated forgetting.