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Galin S, Keren H. The Predictive Potential of Heart Rate Variability for Depression. Neuroscience 2024; 546:88-103. [PMID: 38513761 DOI: 10.1016/j.neuroscience.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 02/29/2024] [Accepted: 03/16/2024] [Indexed: 03/23/2024]
Abstract
Heart rate variability (HRV),a measure of the fluctuations in the intervals between consecutive heartbeats, is an indicator of changes in the autonomic nervous system. A chronic reduction in HRV has been repeatedly linked to clinical depression. However, the chronological and mechanistic aspects of this relationship, between the neural, physiological, and psychopathological levels, remain unclear. In this review we present evidence by which changes in HRV might precede the onset of depression. We describe several pathways that can facilitate this relationship. First, we examine a theoretical model of the impact of autonomic imbalance on HRV and its role in contributing to mood dysregulation and depression. We then highlight brain regions that are regulating both HRV and emotion, suggesting these neural regions, and the Insula in particular, as potential mediators of this relationship. We also present additional possible mediating mechanisms involving the immune system and inflammation processes. Lastly, we support this model by showing evidence that modification of HRV with biofeedback leads to an improvement in some symptoms of depression. The possibility that changes in HRV precede the onset of depression is critical to put to the test, not only because it could provide insights into the mechanisms of the illness but also because it may offer a predictive anddiagnosticphysiological marker for depression. Importantly, it could also help to develop new effective clinical interventions for treating depression.
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Affiliation(s)
- Shir Galin
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel; Gonda Interdisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Hanna Keren
- Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel; Gonda Interdisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel.
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Smith SS, Jahn KN, Sugai JA, Hancock KE, Polley DB. The human pupil and face encode sound affect and provide objective signatures of tinnitus and auditory hypersensitivity disorders. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.12.22.571929. [PMID: 38187580 PMCID: PMC10769427 DOI: 10.1101/2023.12.22.571929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Sound is jointly processed along acoustic and emotional dimensions. These dimensions can become distorted and entangled in persons with sensory disorders, producing a spectrum of loudness hypersensitivity, phantom percepts, and - in some cases - debilitating sound aversion. Here, we looked for objective signatures of disordered hearing (DH) in the human face. Pupil dilations and micro facial movement amplitudes scaled with sound valence in neurotypical listeners but not DH participants with chronic tinnitus (phantom ringing) and sound sensitivity. In DH participants, emotionally evocative sounds elicited abnormally large pupil dilations but blunted and invariant facial reactions that jointly provided an accurate prediction of individual tinnitus and hyperacusis questionnaire handicap scores. By contrast, EEG measures of central auditory gain identified steeper neural response growth functions but no association with symptom severity. These findings highlight dysregulated affective sound processing in persons with bothersome tinnitus and sound sensitivity disorders and introduce approaches for their objective measurement.
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Affiliation(s)
- Samuel S Smith
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston MA, 02114 USA
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston MA 02114 USA
- Lead contact
| | - Kelly N Jahn
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston MA, 02114 USA
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston MA 02114 USA
| | - Jenna A Sugai
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston MA, 02114 USA
| | - Ken E Hancock
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston MA, 02114 USA
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston MA 02114 USA
| | - Daniel B Polley
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston MA, 02114 USA
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston MA 02114 USA
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Ribba B, Peck R, Hutchinson L, Bousnina I, Motti D. Digital Therapeutics as a New Therapeutic Modality: A Review from the Perspective of Clinical Pharmacology. Clin Pharmacol Ther 2023; 114:578-590. [PMID: 37392464 DOI: 10.1002/cpt.2989] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/24/2023] [Indexed: 07/03/2023]
Abstract
The promise of transforming digital technologies into treatments is what drives the development of digital therapeutics (DTx), generally known as software applications embedded within accessible technologies-such as smartphones-to treat, manage, or prevent a pathological condition. Whereas DTx solutions that successfully demonstrate effectiveness and safety could drastically improve the life of patients in multiple therapeutic areas, there is a general consensus that generating therapeutic evidence for DTx presents challenges and open questions. We believe there are three main areas where the application of clinical pharmacology principles from the drug development field could benefit DTx development: the characterization of the mechanism of action, the optimization of the intervention, and, finally, its dosing. We reviewed DTx studies to explore how the field is approaching these topics and to better characterize the challenges associated with them. This leads us to emphasize the role that the application of clinical pharmacology principles could play in the development of DTx and to advocate for a development approach that merges such principles from development of traditional therapeutics with important considerations from the highly attractive and fast-paced world of digital solutions.
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Affiliation(s)
- Benjamin Ribba
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Richard Peck
- Roche Pharma Research and Early Development (pRED), Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, UK
| | - Lucy Hutchinson
- Roche Information Solutions, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Imein Bousnina
- Genentech, A Member of the Roche Group, Washington, DC, USA
| | - Dario Motti
- Roche Information Solutions, F. Hoffmann-La Roche Ltd., Basel, Switzerland
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Yamoah EN, Pavlinkova G, Fritzsch B. The Development of Speaking and Singing in Infants May Play a Role in Genomics and Dementia in Humans. Brain Sci 2023; 13:1190. [PMID: 37626546 PMCID: PMC10452560 DOI: 10.3390/brainsci13081190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
The development of the central auditory system, including the auditory cortex and other areas involved in processing sound, is shaped by genetic and environmental factors, enabling infants to learn how to speak. Before explaining hearing in humans, a short overview of auditory dysfunction is provided. Environmental factors such as exposure to sound and language can impact the development and function of the auditory system sound processing, including discerning in speech perception, singing, and language processing. Infants can hear before birth, and sound exposure sculpts their developing auditory system structure and functions. Exposing infants to singing and speaking can support their auditory and language development. In aging humans, the hippocampus and auditory nuclear centers are affected by neurodegenerative diseases such as Alzheimer's, resulting in memory and auditory processing difficulties. As the disease progresses, overt auditory nuclear center damage occurs, leading to problems in processing auditory information. In conclusion, combined memory and auditory processing difficulties significantly impact people's ability to communicate and engage with their societal essence.
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Affiliation(s)
- Ebenezer N. Yamoah
- Department of Physiology and Cell Biology, School of Medicine, University of Nevada, Reno, NV 89557, USA;
| | | | - Bernd Fritzsch
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA
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Schiller D. Reconsolidation: A paradigm shift. Brain Res Bull 2022; 189:184-186. [PMID: 36096334 DOI: 10.1016/j.brainresbull.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 11/29/2022]
Abstract
This commentary is part of a special issue honoring Karim Nader and his focal role in igniting the reconsolidation field. The commentary describes in broad strokes the evolution of the field, its branches, major challenges, and future endeavors.
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Affiliation(s)
- Daniela Schiller
- Department of Neuroscience, Department of Psychiatry, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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McGill M, Hight AE, Watanabe YL, Parthasarathy A, Cai D, Clayton K, Hancock KE, Takesian A, Kujawa SG, Polley DB. Neural signatures of auditory hypersensitivity following acoustic trauma. eLife 2022; 11:e80015. [PMID: 36111669 PMCID: PMC9555866 DOI: 10.7554/elife.80015] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/14/2022] [Indexed: 11/25/2022] Open
Abstract
Neurons in sensory cortex exhibit a remarkable capacity to maintain stable firing rates despite large fluctuations in afferent activity levels. However, sudden peripheral deafferentation in adulthood can trigger an excessive, non-homeostatic cortical compensatory response that may underlie perceptual disorders including sensory hypersensitivity, phantom limb pain, and tinnitus. Here, we show that mice with noise-induced damage of the high-frequency cochlear base were behaviorally hypersensitive to spared mid-frequency tones and to direct optogenetic stimulation of auditory thalamocortical neurons. Chronic two-photon calcium imaging from ACtx pyramidal neurons (PyrNs) revealed an initial stage of spatially diffuse hyperactivity, hyper-correlation, and auditory hyperresponsivity that consolidated around deafferented map regions three or more days after acoustic trauma. Deafferented PyrN ensembles also displayed hypersensitive decoding of spared mid-frequency tones that mirrored behavioral hypersensitivity, suggesting that non-homeostatic regulation of cortical sound intensity coding following sensorineural loss may be an underlying source of auditory hypersensitivity. Excess cortical response gain after acoustic trauma was expressed heterogeneously among individual PyrNs, yet 40% of this variability could be accounted for by each cell's baseline response properties prior to acoustic trauma. PyrNs with initially high spontaneous activity and gradual monotonic intensity growth functions were more likely to exhibit non-homeostatic excess gain after acoustic trauma. This suggests that while cortical gain changes are triggered by reduced bottom-up afferent input, their subsequent stabilization is also shaped by their local circuit milieu, where indicators of reduced inhibition can presage pathological hyperactivity following sensorineural hearing loss.
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Affiliation(s)
- Matthew McGill
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear InfirmaryBostonUnited States
- Division of Medical Sciences, Harvard Medical SchoolBostonUnited States
| | - Ariel E Hight
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear InfirmaryBostonUnited States
- Division of Medical Sciences, Harvard Medical SchoolBostonUnited States
| | - Yurika L Watanabe
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear InfirmaryBostonUnited States
| | - Aravindakshan Parthasarathy
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear InfirmaryBostonUnited States
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical SchoolBostonUnited States
| | - Dongqin Cai
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear InfirmaryBostonUnited States
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical SchoolBostonUnited States
| | - Kameron Clayton
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear InfirmaryBostonUnited States
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical SchoolBostonUnited States
| | - Kenneth E Hancock
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear InfirmaryBostonUnited States
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical SchoolBostonUnited States
| | - Anne Takesian
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear InfirmaryBostonUnited States
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical SchoolBostonUnited States
| | - Sharon G Kujawa
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear InfirmaryBostonUnited States
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical SchoolBostonUnited States
| | - Daniel B Polley
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear InfirmaryBostonUnited States
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical SchoolBostonUnited States
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