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Napadow V, Li A, Loggia M, Kim J, Mawla I, Desbordes G, Schalock PC, Lerner EA, Tran TN, Ring J, Rosen BR, Kaptchuk TJ, Pfab F. The imagined itch: brain circuitry supporting nocebo-induced itch in atopic dermatitis patients. Allergy 2015; 70:1485-92. [PMID: 26280659 DOI: 10.1111/all.12727] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Psychological factors are known to significantly modulate itch in patients suffering from chronic itch. Itch is also highly susceptible to both placebo and nocebo (negative placebo) effects. Brain activity likely supports nocebo-induced itch, but is currently unknown. METHODS We collected functional MRI (fMRI) data from atopic dermatitis (AD) patients, in a within-subject design, and contrast brain response to nocebo saline understood to be allergen vs open-label saline control. Exploratory analyses compared results to real allergen itch response and placebo responsiveness, evaluated in the same patients. RESULTS Nocebo saline produced greater itch than open saline control (P < 0.01). Compared to open saline, nocebo saline demonstrated greater fMRI response in caudate, dorsolateral prefrontal cortex (dlPFC), and intraparietal sulcus (iPS) - brain regions important for cognitive executive and motivational processing. Exploratory analyses found that subjects with greater dlPFC and caudate activation to nocebo-induced itch also demonstrated greater dlPFC and caudate activation, respectively, for real allergen itch. Subjects reporting greater nocebo-induced itch also demonstrated greater placebo reduction of allergen-evoked itch, suggesting increased generalized modulation of itch perception. CONCLUSIONS Our study demonstrates the capacity of nocebo saline to mimic both the sensory and neural effects of real allergens and provides an insight to the brain mechanisms supporting nocebo-induced itch in AD, thus aiding our understanding of the role that expectations and other psychological factors play in modulating itch perception in chronic itch patients.
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Affiliation(s)
- V. Napadow
- Martinos Center for Biomedical Imaging; Massachusetts General Hospital; Harvard Medical School; Charlestown MA USA
- Department of Radiology; Logan University; Chesterfield MO USA
| | - A. Li
- Martinos Center for Biomedical Imaging; Massachusetts General Hospital; Harvard Medical School; Charlestown MA USA
| | - M.L. Loggia
- Martinos Center for Biomedical Imaging; Massachusetts General Hospital; Harvard Medical School; Charlestown MA USA
| | - J. Kim
- Martinos Center for Biomedical Imaging; Massachusetts General Hospital; Harvard Medical School; Charlestown MA USA
| | - I. Mawla
- Martinos Center for Biomedical Imaging; Massachusetts General Hospital; Harvard Medical School; Charlestown MA USA
| | - G. Desbordes
- Martinos Center for Biomedical Imaging; Massachusetts General Hospital; Harvard Medical School; Charlestown MA USA
| | - P. C. Schalock
- Department of Dermatology; Massachusetts General Hospital; Harvard Medical School; Boston MA USA
| | - E. A. Lerner
- Department of Dermatology; Massachusetts General Hospital; Harvard Medical School; Boston MA USA
| | - T. N. Tran
- Department of Dermatology; Massachusetts General Hospital; Harvard Medical School; Boston MA USA
| | - J. Ring
- Department of Dermatology and Allergy; Technische Universität München; Munich Germany
| | - B. R. Rosen
- Martinos Center for Biomedical Imaging; Massachusetts General Hospital; Harvard Medical School; Charlestown MA USA
| | - T. J. Kaptchuk
- Program in Placebo Studies; Beth Israel Deaconess Medical Center; Harvard Medical School; Boston MA USA
| | - F. Pfab
- Martinos Center for Biomedical Imaging; Massachusetts General Hospital; Harvard Medical School; Charlestown MA USA
- Department of Dermatology and Allergy; Technische Universität München; Munich Germany
- Department of Prevention and Sports Medicine; Technische Universität München; Munich Germany
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52
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Bartels DJP, van Laarhoven AIM, van de Kerkhof PCM, Evers AWM. Placebo and nocebo effects on itch: effects, mechanisms, and predictors. Eur J Pain 2015; 20:8-13. [PMID: 26417885 DOI: 10.1002/ejp.750] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2015] [Indexed: 12/17/2022]
Abstract
Placebo and nocebo effects have been extensively studied in the field of pain and more recently also on itch. In accordance with placebo research on pain, expectancy learning via verbal suggestion or conditioning has shown to induce placebo and nocebo effects on itch, in which the combination of both procedures seems most promising. Moreover, itch can also be transferred 'contagiously' in which suggestion and social behavioural learning seem to play a role. With regard to predictors of placebo and nocebo responding on itch and contagious itch, preliminary evidence suggests a role for individual psychological characteristics and personality traits regarding negative outcome expectancies. Although findings on placebo and nocebo effects on itch seem comparable to pain, we have only just begun to understand the underlying mechanisms and predictors of placebo and nocebo effects on itch.
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Affiliation(s)
- Danielle J P Bartels
- Unit Health, Medical and Neuropsychology, Institute of Psychology, Leiden University, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands
| | - Antoinette I M van Laarhoven
- Unit Health, Medical and Neuropsychology, Institute of Psychology, Leiden University, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands
| | | | - Andrea W M Evers
- Unit Health, Medical and Neuropsychology, Institute of Psychology, Leiden University, Leiden, the Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, the Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
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53
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Schut C, Rädel A, Frey L, Gieler U, Kupfer J. Role of personality and expectations for itch and scratching induced by audiovisual itch stimuli. Eur J Pain 2015; 20:14-8. [DOI: 10.1002/ejp.751] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2015] [Indexed: 11/09/2022]
Affiliation(s)
- C. Schut
- Institute of Medical Psychology; Justus-Liebig-University; Giessen Germany
| | - A. Rädel
- Institute of Medical Psychology; Justus-Liebig-University; Giessen Germany
| | - L. Frey
- Institute of Medical Psychology; Justus-Liebig-University; Giessen Germany
| | - U. Gieler
- Clinics for Dermatology and Allergology; Justus-Liebig-University; Giessen Germany
| | - J. Kupfer
- Institute of Medical Psychology; Justus-Liebig-University; Giessen Germany
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54
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Mochizuki H, Kakigi R. Itch and brain. J Dermatol 2015; 42:761-7. [DOI: 10.1111/1346-8138.12956] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 04/16/2015] [Indexed: 01/23/2023]
Affiliation(s)
- Hideki Mochizuki
- Department of Dermatology; Temple University School of Medicine; Temple Itch Center; Philadelphia Pennsylvania USA
| | - Ryusuke Kakigi
- Department of Integrative Physiology; National Institute for Physiological Sciences; Okazaki Japan
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55
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Placebo Effects on Itch: A Meta-Analysis of Clinical Trials of Patients with Dermatological Conditions. J Invest Dermatol 2015; 135:1234-1243. [DOI: 10.1038/jid.2014.522] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 10/31/2014] [Accepted: 12/01/2014] [Indexed: 01/21/2023]
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56
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Case LK, Pineda J, Ramachandran VS. Common coding and dynamic interactions between observed, imagined, and experienced motor and somatosensory activity. Neuropsychologia 2015; 79:233-45. [PMID: 25863237 DOI: 10.1016/j.neuropsychologia.2015.04.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 03/01/2015] [Accepted: 04/03/2015] [Indexed: 01/25/2023]
Abstract
Motor imagery and perception - considered generally as forms of motor simulation - share overlapping neural representations with motor production. While much research has focused on the extent of this "common coding," less attention has been paid to how these overlapping representations interact. How do imagined, observed, or produced actions influence one another, and how do we maintain control over our perception and behavior? In the first part of this review we describe interactions between motor production and motor simulation, and explore apparent regulatory mechanisms that balance these processes. Next, we consider the somatosensory system. Numerous studies now support a "sensory mirror system" comprised of neural representations activated by either afferent sensation or vicarious sensation. In the second part of this review we summarize evidence for shared representations of sensation and sensory simulation (including imagery and observed sensation), and suggest that similar interactions and regulation of simulation occur in the somatosensory domain as in the motor domain. We suggest that both motor and somatosensory simulations are flexibly regulated to support simulations congruent with our sensorimotor experience and goals and suppress or separate the influence of those that are not. These regulatory mechanisms are frequently revealed by cases of brain injury but can also be employed to facilitate sensorimotor rehabilitation.
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Affiliation(s)
- Laura K Case
- Center for Brain and Cognition, University of California, San Diego, USA; Pain and Integrative Neuroscience Branch, National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, USA.
| | - Jaime Pineda
- Department of Cognitive Science, University of California, San Diego, USA
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57
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Schut C, Muhl S, Reinisch K, Claßen A, Jäger R, Gieler U, Kupfer J. Agreeableness and Self-Consciousness as Predictors of Induced Scratching and Itch in Patients with Psoriasis. Int J Behav Med 2015; 22:726-34. [DOI: 10.1007/s12529-015-9471-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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58
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Lloyd DM, McGlone FP, Yosipovitch G. Somatosensory pleasure circuit: from skin to brain and back. Exp Dermatol 2015; 24:321-4. [PMID: 25607755 DOI: 10.1111/exd.12639] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2015] [Indexed: 12/20/2022]
Abstract
The skin senses serve a discriminative function, allowing us to manipulate objects and detect touch and temperature, and an affective/emotional function, manifested as itch or pain when the skin is damaged. Two different classes of nerve fibre mediate these dissociable aspects of cutaneous somatosensation: (i) myelinated A-beta and A-delta afferents that provide rapid information about the location and physical characteristics of skin contact; and (ii) unmyelinated, slow-conducting C-fibre afferents that are typically associated with coding the emotional properties of pain and itch. However, recent research has identified a third class of C-fibre afferents that code for the pleasurable properties of touch - c-tactile afferents or CTs. Clinical application of treatments that target pleasant, CT-mediated touch (such as massage therapy) could, in the future, provide a complementary, non-pharmacological means of treating both the physical and psychological aspects of chronic skin conditions such as itch and eczema.
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Affiliation(s)
- Donna M Lloyd
- School of Psychology, University of Leeds, Leeds, UK
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59
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Schut C, Grossman S, Gieler U, Kupfer J, Yosipovitch G. Contagious itch: what we know and what we would like to know. Front Hum Neurosci 2015; 9:57. [PMID: 25717300 PMCID: PMC4324061 DOI: 10.3389/fnhum.2015.00057] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 01/20/2015] [Indexed: 11/29/2022] Open
Abstract
All humans experience itch in the course of their life. Even a discussion on the topic of itch or seeing people scratch can evoke the desire to scratch. These events are coined “contagious itch” and are very common. We and others have shown that videos showing people scratching and pictures of affected skin or insects can induce itch in healthy persons and chronic itch patients. In our studies, patients with atopic dermatitis (AD) were more susceptible to visual itch cues than healthy. Also, personality traits like agreeableness and public self-consciousness were associated with induced scratching in skin patients, while neuroticism correlated with induced itch in healthy subjects. The underlying course of contagious itch is not yet fully understood. It is hypothesized that there are human mirror neurons that are active when we imitate actions and/or negative affect. Until now, there has been only limited data on the mechanisms of brain activation in contagious itch though. We have barely begun to understand the underlying physiological reactions and the triggering factors of this phenomenon. We summarize what we currently know about contagious itch and provide some suggestions what future research should focus on.
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Affiliation(s)
- C Schut
- Department of Dermatology and Temple Itch Center, Temple University School of Medicine Philadelphia, PA, USA ; Institute of Medical Psychology, Justus-Liebig-University Giessen, Germany
| | - S Grossman
- Department of Dermatology and Temple Itch Center, Temple University School of Medicine Philadelphia, PA, USA
| | - U Gieler
- Department of Dermatology, University Clinic Giessen, Germany
| | - J Kupfer
- Institute of Medical Psychology, Justus-Liebig-University Giessen, Germany
| | - G Yosipovitch
- Department of Dermatology and Temple Itch Center, Temple University School of Medicine Philadelphia, PA, USA
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60
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Yosipovitch G, Mochizuki H. Neuroimaging of itch as a tool of assessment of chronic itch and its management. Handb Exp Pharmacol 2015; 226:57-70. [PMID: 25861774 DOI: 10.1007/978-3-662-44605-8_4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Chronic itch is a multidimensional physical state strongly associated with emotional and cognitive aspects of suffering that causes the urge to scratch. Pathophysiology, psychological stress, and social milieu can influence itch. Here, we review brain neuroimaging research in humans that detects functional and anatomic changes in health and disease states. New data are emerging that are shaping our understanding of itch mechanisms and scratching-the behavioral response as well as the effect of treatments and brain dynamics during itch. Future developments will continue to expand our knowledge of itch mechanisms, allowing translation to clinical assessment and novel therapies focused on the brain, the final relay of itch transmission.
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Affiliation(s)
- Gil Yosipovitch
- Department of Dermatology and Temple Itch Center, Temple University Medical Center, 3322 North Broad Street, Suite 212, Philadelphia, PA, 19140, USA,
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61
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Mochizuki H, Kakigi R. Central mechanisms of itch. Clin Neurophysiol 2014; 126:1650-60. [PMID: 25534483 DOI: 10.1016/j.clinph.2014.11.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 10/31/2014] [Accepted: 11/18/2014] [Indexed: 10/24/2022]
Abstract
Itch is a complex sensory and emotional experience. Functional brain imaging studies have been performed to identify brain regions associated with this complex experience, and these studies reported that several brain regions are activated by itch stimuli. The possible roles of these regions in itch perception and difference in cerebral mechanism between healthy subjects and chronic itch patients are discussed in this review article. Additionally, the central itch modulation system and cerebral mechanisms of contagious itch, pleasurable sensation evoked by scratching have also been investigated in previous brain imaging studies. We also discuss how these studies advance our understanding of these mechanisms.
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Affiliation(s)
- Hideki Mochizuki
- Department of Integrative Physiology, National Institute for Physiological Sciences, Okazaki, Aichi, Japan; Department of Dermatology and Temple Itch Center, Temple University School of Medicine, Philadelphia, PA, USA.
| | - Ryusuke Kakigi
- Department of Integrative Physiology, National Institute for Physiological Sciences, Okazaki, Aichi, Japan
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62
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Hagenmuller F, Rössler W, Wittwer A, Haker H. Juicy lemons for measuring basic empathic resonance. Psychiatry Res 2014; 219:391-6. [PMID: 24953424 DOI: 10.1016/j.psychres.2014.05.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 01/20/2014] [Accepted: 05/28/2014] [Indexed: 12/25/2022]
Abstract
Watch or even think of someone biting into a juicy lemon and your saliva will flow. This is a phenomenon of resonance, best described by the Perception-Action Model, where a physiological state in a person is activated through observation of this state in another. Within a broad framework of empathy, including manifold abilities depending on the Perception-Action link, resonance has been proposed as one physiological substrate for empathy. Using 49 healthy subjects, we developed a standardized salivation paradigm to assess empathic resonance at the autonomic level. Our results showed that this physiological resonance correlated positively with self-reported empathic concern. The salivation test, delivered an objective and continuous measure, was simple to implement in terms of setup and instruction, and could not easily be unintentionally biased or intentionally manipulated by participants. Therefore, these advantages make such a test a useful tool for assessing empathy-related abilities in psychiatric populations.
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Affiliation(s)
- Florence Hagenmuller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, PO Box 1930, 8021 Zurich, Switzerland; Collegium Helveticum, University of Zurich and ETH Zurich, Zurich, Switzerland.
| | - Wulf Rössler
- Collegium Helveticum, University of Zurich and ETH Zurich, Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM-27), University of Sao Paulo, Sao Paulo, Brazil
| | - Amrei Wittwer
- Collegium Helveticum, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Helene Haker
- Collegium Helveticum, University of Zurich and ETH Zurich, Zurich, Switzerland; Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
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63
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Role of conditioning and verbal suggestion in placebo and nocebo effects on itch. PLoS One 2014; 9:e91727. [PMID: 24646924 PMCID: PMC3960153 DOI: 10.1371/journal.pone.0091727] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 02/13/2014] [Indexed: 12/31/2022] Open
Abstract
Placebo and nocebo effects are known to play a key role in treatment effects in a wide variety of conditions. These effects have frequently been investigated with regard to pain and also in other physical sensations, but have hardly been investigated with regard to itch. In addition, neither in pain nor in any other physical sensation, the single and combined contribution of the expectancy mechanisms of conditioning and verbal suggestion have ever been investigated in both placebo and nocebo effects within one design. For the first time, the role of verbal suggestion and conditioning in placebo and nocebo effects on itch was experimentally investigated. Expectations about itch stimuli were induced in healthy subjects by verbal suggestion, conditioning, or a combination of both procedures, and compared with a control group without expectation induction. Itch was induced electrically by means of quantitative sensory testing. Significant placebo and nocebo effects were induced in the group in which combined procedures of conditioning and verbal suggestion were applied in comparison with the control group. The conditioning and verbal suggestion procedures applied individually did not induce significant placebo and nocebo effects when compared with the control group. The results of this study extend existing evidence on different physical sensations, like pain, by showing that also for itch, the combination of conditioning and verbal suggestion is most promising in inducing both placebo and nocebo effects. More research on placebo and nocebo effects at a perceptive and neurobiological level is warranted to further elucidate the common and specific mechanisms underlying placebo and nocebo effects on itch and other physical sensations.
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64
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Abstract
Physical complaints, such as pain, can be effectively altered by placebo and nocebo effects due to induction of positive or negative expectations. While verbal suggestion and conditioning are recognized as playing a key role in placebo and nocebo effects on pain, these mechanisms have barely been investigated with regard to other somatosensory sensations, such as itch. Results on contagious itch in both animals and humans suggest that itch sensations might be even more susceptible for placebo and nocebo effects than pain. Research on placebo and nocebo effects on pain and itch can further deliver insight into the common and specific mechanisms underlying these effects in different physical complaints. Work of our research group on verbal suggestions inducing nocebo effects demonstrated an important role of verbal suggestions with regard to itch, with stronger nocebo effects on itch than a comparable procedure for pain. Recent work also demonstrated that placebo and nocebo effects on itch sensations were most effectively induced by procedures that consist of both conditioning and verbal suggestion principles. This work adds to previous prospective studies showing that expectation mechanisms, such as preservative worrying about negative consequences, are relatively consistent predictors of future disease outcomes, including itch, in chronic somatic conditions. Future studies should focus on the specific psychoneurobiological mechanisms of placebo and nocebo effects in various physical sensations, to get insight into the common and specific effects and to contribute to the long-term and clinically relevant use of placebo effects in clinical practice.
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Affiliation(s)
- Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, 9555, 2300, Leiden, The Netherlands,
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65
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Abstract
The itch-scratch reflex serves as a protective mechanism in everyday life. However, chronic persistent itching can be devastating. Despite the clinical importance of the itch sensation, its mechanism remains elusive. In the past decade, substantial progress has been made to uncover the mystery of itching. Here, we review the molecules, cells, and circuits known to mediate the itch sensation, which, coupled with advances in understanding the pathophysiology of chronic itching conditions, will hopefully contribute to the development of new anti-itch therapies.
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Affiliation(s)
- Liang Han
- The Solomon H. Snyder Department of Neuroscience, Center for Sensory Biology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205;
| | - Xinzhong Dong
- The Solomon H. Snyder Department of Neuroscience, Center for Sensory Biology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205;
- Howard Hughes Medical Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205;
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66
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Madsen EA, Persson T, Sayehli S, Lenninger S, Sonesson G. Chimpanzees show a developmental increase in susceptibility to contagious yawning: a test of the effect of ontogeny and emotional closeness on yawn contagion. PLoS One 2013; 8:e76266. [PMID: 24146848 PMCID: PMC3797813 DOI: 10.1371/journal.pone.0076266] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 08/22/2013] [Indexed: 11/18/2022] Open
Abstract
Contagious yawning has been reported for humans, dogs and several non-human primate species, and associated with empathy in humans and other primates. Still, the function, development and underlying mechanisms of contagious yawning remain unclear. Humans and dogs show a developmental increase in susceptibility to yawn contagion, with children showing an increase around the age of four, when also empathy-related behaviours and accurate identification of others' emotions begin to clearly evince. Explicit tests of yawn contagion in non-human apes have only involved adult individuals and examined the existence of conspecific yawn contagion. Here we report the first study of heterospecific contagious yawning in primates, and the ontogeny of susceptibility thereto in chimpanzees, Pan troglodytes verus. We examined whether emotional closeness, defined as attachment history with the yawning model, affected the strength of contagion, and compared the contagiousness of yawning to nose-wiping. Thirty-three orphaned chimpanzees observed an unfamiliar and familiar human (their surrogate human mother) yawn, gape and nose-wipe. Yawning, but not nose-wiping, was contagious for juvenile chimpanzees, while infants were immune to contagion. Like humans and dogs, chimpanzees are subject to a developmental trend in susceptibility to contagious yawning, and respond to heterospecific yawn stimuli. Emotional closeness with the model did not affect contagion. The familiarity-biased social modulatory effect on yawn contagion previously found among some adult primates, seem to only emerge later in development, or be limited to interactions with conspecifics. The influence of the 'chameleon effect', targeted vs. generalised empathy, perspective-taking and visual attention on contagious yawning is discussed.
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Affiliation(s)
- Elainie Alenkær Madsen
- Department of Cognitive Science, Lund University, Lund, Sweden
- Department of Semiotics, Centre for Languages and Literature, Lund University, Lund, Sweden
| | - Tomas Persson
- Department of Cognitive Science, Lund University, Lund, Sweden
| | - Susan Sayehli
- Department of Linguistics, Centre for Languages and Literature, Lund University, Lund, Sweden
- Humanities Lab, Lund University, Lund, Sweden
| | - Sara Lenninger
- Department of Semiotics, Centre for Languages and Literature, Lund University, Lund, Sweden
| | - Göran Sonesson
- Department of Semiotics, Centre for Languages and Literature, Lund University, Lund, Sweden
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67
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Abstract
Expectation of treatment side effects is consistently linked with those symptoms being realised. Patient expectations, including those generated by the informed consent process, can have a large influence on the side effects that patients feel after starting a new medical treatment. Such symptoms may be the result of the nocebo effect, whereby the expectation of side effects leads to them being experienced. Side effects may also be due to the misattribution of pre-existing or unrelated symptoms to the new medication. Medical professionals' own negative beliefs about a treatment, especially generic drugs, may further enhance patients' expectations of adverse effects. The news media may also influence expectations, particularly when media attention is directed towards a health or medication scare. This field of research has ethical and clinical implications for both medical professionals and the news media with respect to the level and type of information about treatment side effects that is provided to patients or members of the public.
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Affiliation(s)
- Kate Faasse
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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68
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Mochizuki H, Baumgärtner U, Kamping S, Ruttorf M, Schad LR, Flor H, Kakigi R, Treede RD. Cortico-subcortical activation patterns for itch and pain imagery. Pain 2013; 154:1989-1998. [PMID: 23769719 DOI: 10.1016/j.pain.2013.06.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 06/03/2013] [Accepted: 06/04/2013] [Indexed: 12/19/2022]
Abstract
The imagery of itch and pain evokes emotional responses and covert motor responses (scratching to itch and withdrawal to pain). This suggests some similarity in cerebral mechanisms. However, itch is more socially contagious than pain, as evidenced by the fact that scratching behaviors can be easily initiated by watching itch-inducing situations, whereas withdrawal is less easily initiated by watching painful situations. Thus, we assumed that the cerebral mechanisms of itch imagery partly differ from those of pain imagery in particular with respect to motor regions. We addressed this issue in 18 healthy subjects using functional magnetic resonance imaging. The subjects were instructed to imagine itch and pain sensations in their own bodies while viewing pictures depicting stimuli associated with these sensations. Itch and pain imagery activated the anterior insular cortex (aIC) and motor-related regions such as supplementary motor area, basal ganglia, thalamus, and cerebellum. Activity in these regions was not significantly different between itch and pain imagery. However, functional connectivity between motor-related regions and the aIC showed marked differences between itch and pain imagery. Connectivity with the aIC was stronger in the primary motor and premotor cortices during pain imagery and stronger in the globus pallidus during itch imagery. These findings indicate that brain regions associated with imagery of itch are the same as those involved in imagery of pain, but their functional networks differ. These differences in brain networks may explain why motor responses to itch are more socially contagious than those related to pain.
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Affiliation(s)
- Hideki Mochizuki
- Department of Neurophysiology, Center for Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany Department of Integrative Physiology, National Institute for Physiological Sciences, Okazaki, Japan Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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69
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Abstract
Pruritus and psyche are intricately and reciprocally related, with psychophysiological evidence and psychopathological explanations helping us to understand their complex association. Their interaction may be conceptualized and classified into 3 groups: pruritic diseases with psychiatric sequelae, pruritic diseases aggravated by psychosocial factors, and psychiatric disorders causing pruritus. Management of chronic pruritus is directed at treating the underlying causes and adopting a multidisciplinary approach to address the dermatologic, somatosensory, cognitive, and emotional aspects. Pharmcotherapeutic agents that are useful for chronic pruritus with comorbid depression and/or anxiety comprise selective serotonin reuptake inhibitors, mirtazapine, tricyclic antidepressants (amitriptyline and doxepin), and anticonvulsants (gabapentin, pregabalin); the role of neurokinin receptor-1 antagonists awaits verification. Antipsychotics are required for treating itch and formication associated with schizophrenia and delusion of parasitosis (including Morgellons disease).
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Affiliation(s)
- Hong Liang Tey
- Department of Dermatology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA
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70
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Ständer S, Stumpf A, Osada N, Wilp S, Chatzigeorgakidis E, Pfleiderer B. Gender differences in chronic pruritus: women present different morbidity, more scratch lesions and higher burden. Br J Dermatol 2013; 168:1273-80. [DOI: 10.1111/bjd.12267] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2013] [Indexed: 12/20/2022]
Affiliation(s)
- S. Ständer
- Competence Centre Chronic Pruritus; Department of Dermatology; University Hospital of Münster; Albert-Schweitzer-Campus 1; D-48149; Münster; Germany
| | - A. Stumpf
- Department of Psychosomatics and Psychotherapy; University Hospital of Münster; Albert-Schweitzer-Campus 1; D-48149; Münster; Germany
| | - N. Osada
- Department of Medical Informatics and Biomathematics; University Hospital of Münster; Albert-Schweitzer-Campus 1; D-48149; Münster; Germany
| | - S. Wilp
- Department of Clinical Radiology; University Hospital of Münster; Albert-Schweitzer-Campus 1; D-48149; Münster; Germany
| | - E. Chatzigeorgakidis
- Competence Centre Chronic Pruritus; Department of Dermatology; University Hospital of Münster; Albert-Schweitzer-Campus 1; D-48149; Münster; Germany
| | - B. Pfleiderer
- Department of Clinical Radiology; University Hospital of Münster; Albert-Schweitzer-Campus 1; D-48149; Münster; Germany
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71
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Ward J, Burckhardt V, Holle H. Contagious scratching: shared feelings but not shared body locations. Front Hum Neurosci 2013; 7:122. [PMID: 23675331 PMCID: PMC3646246 DOI: 10.3389/fnhum.2013.00122] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 03/19/2013] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jamie Ward
- School of Psychology, University of Sussex Brighton, UK
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72
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Lopez C, Falconer CJ, Mast FW. Being moved by the self and others: influence of empathy on self-motion perception. PLoS One 2013; 8:e48293. [PMID: 23326302 PMCID: PMC3543431 DOI: 10.1371/journal.pone.0048293] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 09/24/2012] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The observation of conspecifics influences our bodily perceptions and actions: Contagious yawning, contagious itching, or empathy for pain, are all examples of mechanisms based on resonance between our own body and others. While there is evidence for the involvement of the mirror neuron system in the processing of motor, auditory and tactile information, it has not yet been associated with the perception of self-motion. METHODOLOGY/PRINCIPAL FINDINGS We investigated whether viewing our own body, the body of another, and an object in motion influences self-motion perception. We found a visual-vestibular congruency effect for self-motion perception when observing self and object motion, and a reduction in this effect when observing someone else's body motion. The congruency effect was correlated with empathy scores, revealing the importance of empathy in mirroring mechanisms. CONCLUSIONS/SIGNIFICANCE The data show that vestibular perception is modulated by agent-specific mirroring mechanisms. The observation of conspecifics in motion is an essential component of social life, and self-motion perception is crucial for the distinction between the self and the other. Finally, our results hint at the presence of a "vestibular mirror neuron system".
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Affiliation(s)
- Christophe Lopez
- Department of Psychology, University of Bern, Bern, Switzerland.
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73
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Lloyd D, Hall E, Hall S, McGlone F. Can itch-related visual stimuli alone provoke a scratch response in healthy individuals? Br J Dermatol 2012; 168:106-11. [DOI: 10.1111/bjd.12132] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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74
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Neural basis of contagious itch and why some people are more prone to it. Proc Natl Acad Sci U S A 2012; 109:19816-21. [PMID: 23150550 DOI: 10.1073/pnas.1216160109] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Watching someone scratch himself can induce feelings of itchiness in the perceiver. This provides a unique opportunity to characterize the neural basis of subjective experiences of itch, independent of changes in peripheral inputs. In this study, we first established that the social contagion of itch is essentially a normative response (experienced by most people), and that the degree of contagion is related to trait differences in neuroticism (i.e., the tendency to experience negative emotions), but not to empathy. Watching video clips of someone scratching (relative to control videos of tapping) activated, as indicated by functional neuroimaging, many of the neural regions linked to the physical perception of itch, including anterior insular, primary somatosensory, and prefrontal (BA44) and premotor cortices. Moreover, activity in the left BA44, BA6, and primary somatosensory cortex was correlated with subjective ratings of itchiness, and the responsivity of the left BA44 reflected individual differences in neuroticism. Our findings highlight the central neural generation of the subjective experience of somatosensory perception in the absence of somatosensory stimulation. We speculate that the habitual activation of this central "itch matrix" may give rise to psychogenic itch disorders.
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