Yawning-Its anatomy, chemistry, role, and pathological considerations

Contagious yawning in African painted dogs

Contagious yawning (CY), which is yawning elicited by sensing another yawning, has been observed only in social species and is considered linked to high sociality. Although this idea-the social communication hypothesis-is supported by previous studies, investigating the occurrence of CY in various species remains necessary. We investigated the occurrence of CY in one of the most social canine species, the African painted dog (Lycaon pictus). We recorded 1387 yawn events from five pairs (10 individuals) in captivity. Temporal analysis showed that subsequent yawns occurred frequently within 15 s or 30 s after spontaneous yawns (SYs). SYs that were detectable by another individual (i.e., visible to the other individual or performed in close proximity) were more likely to elicit subsequent yawns by the other individual. However, the influence of contextual factors on CY differed according to the time window, implying that a conservative time window should be used to reduce overcounting of CY and misattribution of its determinants. The proportion of CY was positively related to time spent in physical proximity to another, a proxy for a social bond. Overall, our results provide the first evidence of CY in African painted dogs and further support the notion that such behavior is prevalent among social animals. They also strongly imply that an appropriate time window should be used to define yawn contagion.

Yawning informs behavioural state changing in wild spotted hyaenas

Abstract

Yawning is a complex behaviour linked to several physiological (e.g. drowsiness, arousal, thermoregulation) and social phenomena (e.g. yawn contagion). Being yawning an evolutionary well-conserved, fixed action pattern widespread in vertebrates, it is a valuable candidate to test hypotheses on its potential functions across the different taxa. The spotted hyaena (Crocuta crocuta), the most social and cooperative species of the Hyaenidae family, is a good model to test hypotheses on yawning correlates and significances. Through an accurate sequential analysis performed on a group of wild hyaenas, we found that yawning mainly occurred during an imminent behavioural state changing in both juveniles and adults and that seeing others’ yawn elicited a mirror response in the receiver, thus demonstrating that yawn contagion is present in this species. These results taken together suggest that yawning is linked to a behavioural state change of the yawner and that such change is caught by the observers that engage in a motor resonance phenomenon, yawn contagion, possibly effective in anticipating yawners’ motor actions. Although additional data are necessary to verify whether yawn contagion translates into subsequent motor convergence and alignment, our data suggest that both spontaneous and contagious yawning can be fundamental building blocks on the basis of animal synchronisation in highly social and cooperative species.

Significant statement

Yawning is pervasive in many animal species, including humans. It is considered as a polyfunctional cue that has a role in regulating social interactions. While several studies focussed on yawning functions in primates, a little amount of effort was devoted to exploring this behaviour in social carnivores. We monitored a group of wild spotted hyaenas (Crocuta crocuta), which is one of the most cooperative carnivore species. In both immature and adult subjects, we found that a subject frequently changed its behavioural state after spontaneously yawning and that seeing others’ yawn elicited a mirror response in the observer. Although additional data are necessary to verify whether yawn contagion translates into subsequent motor convergence and alignment, our data suggest that both spontaneous and contagious yawning can be fundamental building blocks on the basis of animal synchronisation in highly social and cooperative species.

Yawning and airway physiology: a scoping review and novel hypothesis

Background and purpose

Yawning is a stereotypical complex muscular movement and is commonly executed by most vertebrates. In seconds, the entire airway is fully dilated and surrounding muscles are powerfully stretched, most prominently around the pharynx. To date, yawning has been rarely studied, and as of yet there is no consensus on its main function.

Material and methods

To investigate a mechanical airway function for yawning, a literature search was conducted to relate the frequency of yawning and obstructive airway conditions.

Results

The results show that changes in obstructive airway conditions and alteration of the frequency of yawning are temporally related.

Interpretation

These relationships, however, cannot be interpreted as causal, nor can they be extrapolated to explain the function of yawning. Yet airway management and yawning share many physiological characteristics. We therefore propose a novel hypotheses: yawning plays a significant role in airway physiology by muscle repositioning and widening the airway lumen, thereby securing long-term oxygenation.

The sigh and related behaviors

Breathing is a critical, complex, and highly integrated behavior. Normal rhythmic breathing, also referred to as eupnea, is interspersed with different breathing related behaviors. Sighing is one of such behaviors, essential for maintaining effective gas exchange by preventing the gradual collapse of alveoli in the lungs, known as atelectasis. Critical for the generation of both sighing and eupneic breathing is a region of the medulla known as the preBötzinger Complex (preBötC). Efforts are underway to identify the cellular pathways that link sighing as well as sneezing, yawning, and hiccupping with other brain regions to better understand how they are integrated and regulated in the context of other behaviors including chemosensation, olfaction, and cognition. Unraveling these interactions may provide important insights into the diverse roles of these behaviors in the initiation of arousal, stimulation of vigilance, and the relay of certain behavioral states. This chapter focuses primarily on the function of the sigh, how it is locally generated within the preBötC, and what the functional implications are for a potential link between sighing and cognitive regulation. Furthermore, we discuss recent insights gained into the pathways and mechanisms that control yawning, sneezing, and hiccupping.

Yawning in the history of psychiatry

Yawning is a fascinating physiological behaviour that has been poorly addressed except in old medical books. Whereas the purpose of this behaviour is still not clearly identified, the ancient authors made it a clinical symptom, especially a psychological one. After presenting some current notions about yawning, we review publications on yawning written by physicians, from antiquity to the twentieth century, and, in particular, those dealing with psychological and psychiatric aspects.

Fetal movements: the origin of human behaviour

The study of the onset and ontogeny of human behaviour has made it clear that a multitude of fetal movement patterns are spontaneously generated, and that there is a close association between activity and the development of peripheral and central structures. The embryo starts moving by 7.5 week's gestation; 2 to 3 weeks later, a number of movement patterns including general movements, isolated limb and head movements, hiccup, and breathing movements, appear. Some movements (e.g. yawning, smiling, 'pointing'; we show these in eight videos in this review) precede life-long patterns; others have intrauterine functions, such as sucking/swallowing for amniotic fluid regulation, breathing movements for lung development, or eye movements for retinal cell diversity. In cases of developmental brain dysfunction, fetal general movements alter their sequence and gestalt, which suggests a dysfunction of the developing nervous system. The scarcity of longitudinal studies calls for further comprehensive research on the predictive value of prenatal functional deviations. What this paper adds Motor output can occur in the absence of sensory input. Structural development is activity-dependent. Fetal general movements are among the first movement patterns to occur. Pregnancy-related and maternal factors impact quantity and modulation of fetal general movements. Prenatal general movement assessment has not yet brought the expected breakthrough.

Yawn-like behavior in captive common bottlenose dolphins (Tursiops truncatus)

Yawning is an involuntary action that begins with a slow opening of the mouth with inhalation, followed by a maximum gaping phase, and ends with a short exhalation and the closing of the mouth. A wide variety of vertebrate species, including humans, yawn. Here, we report underwater yawn-like behavior in three captive common bottlenose dolphins, inferred from 119-h of observations. Five cases of yawn-like behavior were selected out of 2045 open-mouth behaviors, after removing intentional open-mouth behaviors. Yawn-like behaviors were chosen that had a mouth open-close duration ratio of ≤ 1 (duration of Phase 3, the period of mouth closing after maximum opening, divided by the duration of Phase 1, the period of mouth opening from start to maximum opening). Naïve human evaluators selected "yawn-like" behaviors. All five cases of yawn-like behavior occurred during inactive periods, similar to human yawns. In three of the five cases, inactivity levels significantly decreased within 4 min after the yawn-like behavior; therefore, yawn-like behavior in dolphins may increase their arousal level in drowsy states. Thus, the yawn-like behavior of dolphins, without breathing, is similar to yawning in terrestrial animals, including humans.

Sex-Specific Effects of Stress on Respiratory Control: Plasticity, Adaptation, and Dysfunction

As our understanding of respiratory control evolves, we appreciate how the basic neurobiological principles of plasticity discovered in other systems shape the development and function of the respiratory control system. While breathing is a robust homeostatic function, there is growing evidence that stress disrupts respiratory control in ways that predispose to disease. Neonatal stress (in the form of maternal separation) affects "classical" respiratory control structures such as the peripheral O₂ sensors (carotid bodies) and the medulla (e.g., nucleus of the solitary tract). Furthermore, early life stress disrupts the paraventricular nucleus of the hypothalamus (PVH), a structure that has emerged as a primary determinant of the intensity of the ventilatory response to hypoxia. Although underestimated, the PVH's influence on respiratory function is a logical extension of the hypothalamic control of metabolic demand and supply. In this article, we review the functional and anatomical links between the stress neuroendocrine axis and the medullary network regulating breathing. We then present the persistent and sex-specific effects of neonatal stress on respiratory control in adult rats. The similarities between the respiratory phenotype of stressed rats and clinical manifestations of respiratory control disorders such as sleep-disordered breathing and panic attacks are remarkable. These observations are in line with the scientific consensus that the origins of adult disease are often found among developmental and biological disruptions occurring during early life. These observations bring a different perspective on the structural hierarchy of respiratory homeostasis and point to new directions in our understanding of the etiology of respiratory control disorders. © 2021 American Physiological Society. Compr Physiol 11:1-38, 2021.

Premonitory symptoms in migraine from China: A multi-clinic study of 4821 patients

OBJECTIVE

To observe the prevalence and characteristics of premonitory symptoms in Chinese migraineurs and explore their associations with migraine-related factors.

METHOD

Migraineurs who visited a tertiary headache clinic and one of nine neurology clinics between May 2014 and November 2019 were studied.

RESULT

Among the 4821 patients meeting the migraine criteria (International Classification of Headache Disorders, 3rd edition), 1038 (21.5%) patients experienced at least one premonitory symptom. The most common premonitory symptoms were neck stiffness, dizziness, yawning and drowsiness. The logistic regression analysis demonstrated that aura, photophobia, aggravation by routine physical activity, triggers, family history, depression, coffee consumption and physical exercise were associated with an increased probability of experiencing premonitory symptoms (p ≤ 0.001). The premonitory symptoms of migraine with and without aura differ in prevalence and most common symptoms. The cluster analysis revealed pairwise clustering of the following premonitory symptoms: Photophobia/phonophobia, concentration change/dysesthesia, loquacity/overactivity, yawning/drowsiness, fatigue/dizziness, and mood change/irritability. The correlation analysis of triggers and premonitory symptoms revealed that temperature change, environment change, sleep disorder, activity and stress were related to multiple premonitory symptoms, and that food, light, menstruation, alcohol and odor were related to special premonitory symptoms (p ≤ 0.001).

CONCLUSION

The prevalence of premonitory symptoms among migraineurs in China is 21.5%. Some factors influence the probability of experiencing premonitory symptoms. Paired premonitory symptoms in the clustering analysis may share similar origins. Certain triggers associated with multiple premonitory symptoms may induce brain dysfunction; however, other triggers that overlap with corresponding special premonitory symptoms may be premonitory symptoms or a form of premonitory symptom.

Follow-Up of a Case of Dopamine-Mediated Yawning-Fatigue-Syndrome Responsive to Opioids, Successful Desensitization via Graded Activity Treatment

A 60-year-old man suffering from recurrent attacks of yawning-fatigue-syndrome, triggered by mild exercise of his right leg since a temporary lumbar disc herniation 9 years ago, was initially treated with the oral µ-opioid-receptor agonist tilidine before each bout of exercise (see Dibaj et al. 2019 JAMA Neurology 2019;77:254). During the first few months, this treatment continuously prolonged the time without exercise-triggered yawning and fatigue. In the next few months of treatment, exercise was increased in a graded manner to alleviate the yawning-fatigue-syndrome. The number of repetitions of the physical exercises was gradually increased without taking the opioid beforehand. After several months, almost the same effort level without medication could be achieved by graded activity as before under the influence of opioid medication. Graded physical activity can thus disrupt complex pathophysiological mechanisms leading to yawning and fatigue.

Earlier than previously thought: Yawn contagion in preschool children

Yawning is a primitive and stereotyped motor action involving orofacial, laryngeal, pharyngeal, thoracic and abdominal muscles. Contagious yawning, an involuntarily action induced by viewing or listening to others' yawns, has been demonstrated in human and several non-human species. Previous studies with humans showed that infants and preschool children, socially separated during video experiments, were not infected by others' yawns. Here, we tested the occurrence of yawn contagion in 129 preschool children (ranging from 2.5 to 5.5 years) belonging to five different classes by video recording them in their classrooms during the ordinary school activities. As it occurs in adult humans, children of all ages were infected by others' yawns within the 2 min after the perception of the stimulus. The yawn contagion occurred earlier than previously thought. For children, it appears that the natural social setting is more conducive to yawn contagion than the inherently artificial experimental approach. Moreover, children's gender did not affect the level of contagious yawning. The neural, emotional and behavioural traits of preschool children are probably not sufficiently mature to express variability between boys and girls; nevertheless, children appeared to be already well equipped with the 'neural toolkit' necessary for expressing yawn contagion.

Taste association capabilities differ in high- and low-yawning rats versus outbred Sprague-Dawley rats after prolonged sugar consumption

Yawning is a stereotypical behavior pattern commonly associated with other behaviors such as grooming, sleepiness, and arousal. Several differences in behavioral and neurochemical characteristics have been described in high-yawning (HY) and low-yawning (LY) sublines from Sprague-Dawley (SD) rats that support they had changes in the neural mechanism between sublines. Differences in behavior and neurochemistry observed in yawning sublines could also overlap in processes needed during taste learning, particularly during conditioned taste aversion (CTA) and its latent inhibition. Therefore, the aim of this study was to analyze taste memory differences, after familiarization to novel or highly sweet stimuli, between yawning sublines and compare them with outbred SD rats. First, we evaluated changes in appetitive response during long-term sugar consumption for 14 days. Then, we evaluated the latent inhibition of CTA strength induced by this long pre-exposure, and we also measured aversive memory extinction rate. The results showed that SD rats and the two sublines developed similar CTA for novel sugar and significantly stronger appetitive memory after long-term sugar exposure. However, after 14 days of sugar exposure, HY and LY sublines were unable to develop latent inhibition of CTA after two acquisition trials and had a slower aversive memory extinction rate than outbreed rats. Thus, the inability of the HY and LY sublines to develop latent inhibition of CTA after long-term sugar exposure could be related to the time/context processes involved in long-term appetitive re-learning, and in the strong inbreeding that characterizes the behavioral traits of these sublines, suggesting that inbreeding affects associative learning, particularly after long-term exposure to sweet stimuli which reflects high familiarization.

Auditory Contagious Yawning Is Highest Between Friends and Family Members: Support to the Emotional Bias Hypothesis

Contagious yawning differs from spontaneous yawning because it occurs when an individual yawns in response to someone else’s yawn. In Homo sapiens and some non-human primates contagious yawning is higher between strongly than weakly bonded individuals. Up to date, it is still unclear whether this social asymmetry underlies emotional contagion (a basic form of empathy preferentially involving familiar individuals) as predicted by the Emotional Bias Hypothesis (EBH) or is linked to a top-down, selective visual attention bias (with selective attention being preferentially directed toward familiar faces) as predicted by the Attentional Bias Hypothesis (ABH). To verify whether the visual attentional bias explained the yawn contagion bias or not, in this study, we considered only yawns that could be heard but not seen by potential responders (auditory yawns). Around 294 of auditory yawning occurrences were extrapolated from over 2000 yawning bouts collected in free ranging humans for over nine years. Via GLMM, we tested the effect of intrinsic features (i.e., gender and age) and social bond (from strangers to family members) on yawn. The individual identity of the subjects (trigger and potential responder) was included as random factor. The social bond significantly predicted the occurrence of auditory yawn contagion, which was highest between friends and family members. A gender bias was also observed, with women responding most frequently to others’ yawns and men being responded to most frequently by others. These results confirm that social bond is per se one of the main drivers of the differences in yawn contagion rates between individuals in support of the EBH of yawn contagion.

Pathological Yawning in Patients with Acute Middle Cerebral Artery Infarction: Prognostic Significance and Association with the Infarct Location

Background:

Pathological yawning is a compulsive, frequent, repetitive yawning triggered by a specific reason besides fatigue or boredom. It may be related to iatrogenic, neurologic, psychiatric, gastrointestinal, or metabolic disorders. Moreover, it could also be seen in the course of an ischemic stroke.

Aims:

To determine whether pathological yawning is a prognostic marker of middle cerebral artery stroke and evaluate its relationship with the infarct location.

Study Design:

Cross-sectional study.

Methods:

We examined 161 patients with acute middle cerebral artery stroke, consecutively admitted to emergency department. Demographic information, stroke risk factors, stroke type according to Trial of Org 10172 in Acute Stroke Treatment classification, blood oxygen saturation, body temperature, blood pressure, heart rate, glucose levels, daytime of stroke onset, National Institutes of Health Stroke Scale score (National Institutes of Health Stroke Scale score, at admission and 24 h), modified Rankin scale (at 3 months), and infarct locations were documented. Pathological yawning was defined as ≥3 yawns/15 min. All patients were observed for 6 hours to detect pathological yawning. National Institutes of Health Stroke Scale score >10 was determined as severe stroke. The correlation between the presence of pathological yawning and stroke severity, infarct location, and the short- and long-term outcomes of the patients were evaluated.

Results:

Sixty-nine (42.9%) patients had pathological yawning and 112 (69.6%) had cortical infarcts. Insular and opercular infarcts were detected in 65 (40.4%) and 54 (33.5%) patients, respectively. Pathological yawning was more frequently observed in patients with cortical, insular, and opercular infarcts (p<0.05). Pathological yawning was related to higher National Institutes of Health Stroke Scale scores. Patients with severe stroke (National Institutes of Health Stroke Scale score ≥10) presented with more pathological yawning than those with mild to moderate strokes (p<0.05). The clinical outcomes and mortality rates showed no significant relationship with the occurrence of pathological yawning.

Conclusion:

Pathological yawning in middle cerebral artery stroke was associated with stroke severity, presence of cortical involvement, and insular and opercular infarcts. However, no association was found with long-term outcome and mortality.

The physiological experiments of Constantin von Economo on the central pathways of mastication and deglutition

The first study of Constantin von Economo on the mammalian brain was published in 1902. Experiments were carried out in rabbits at the Physiological Institute headed by Siegmund von Exner-Ewarten in Vienna to investigate the central pathways of chewing and swallowing. After placing cortical lesions, Economo applied cortical and subcortical electrical stimulation to obtain masticatory movements, and tracked degenerated fibers by means of the Marchi method. He traced fibers through the internal capsule, ventral nucleus of the thalamus, subthalamic nucleus, substantia nigra and its connections with the motor nucleus of the trigeminal nerve, and nucleus solitarius. He suggested that the substantia nigra is responsible for coordinating alimentation movements, with the involvement of cranial nerves V, VII, IX and X as well. We discuss these findings in a historical and a modern perspective, including the concept of a central pattern generator in the pontine reticular formation and its interaction with the nucleus solitarius. Today we understand that mastication is a voluntary action controlled by motor cortical areas, by motoneurons of the trigeminal, and by a neural pattern generator in the pons. On the other hand, deglutition comprises 'reflex swallowing' triggered by sensory fibers of cranial nerves V, IX and X, and 'voluntary swallowing' which may be controlled by both cortical fields and subcortical areas, such as the internal capsule, the hypothalamus and the mesencephalic reticular formation.

Manipulating neck temperature alters contagious yawning in humans

The existence of yawning across a diverse array of species has led many researchers to postulate its neurological significance. One hypothesis, which has garnered recent support, posits that yawns function to cool the brain by flushing hyperthermic blood away from the skull while simultaneously introducing a cooler arterial supply. The current study tested this hypothesis by examining how manipulations aimed at modifying carotid artery temperature, which in turn directly alters cranial temperature, influences contagious yawning in humans. Participants held either a warm (46 °C), cold (4 °C) or room temperature (22 °C) pack firmly to their neck, just over their carotid arteries, for a period of five minutes prior to watching a contagious yawning stimulus. Thermographic imaging verified that these manipulations produced predicted changes in temperature at the superomedial orbital area, a region previously used as a noninvasive measure of brain temperature (i.e., the brain temperature tunnel). As predicted by past research, both the urge to yawn and overall yawn frequency significantly diminished in the cooling condition (p < .05). Less than half (48.5%) of the participants in the cooling condition reported the urge to yawn, while this urge was expressed by the vast majority of participants in the warming condition (84.8%). Moreover, there was a threefold difference in the mean number of yawns per participant between the cooling and warming conditions (0.364 compared to 1.121). These findings are consistent with previous research indicating that yawns function as a compensatory brain cooling mechanism.

Yawning in neurology: a review

ABSTRACT Yawning is a stereotyped physiological behavior that can represent a sign or symptom of several conditions, such as stroke, parakinesia brachialis oscitans, parkinsonism, Parkinson’s disease and epilepsy. More rarely, it can occur in patients with intracranial hypertension, brain tumor, multiple sclerosis, migraine, Chiari malformation type I, and amyotrophic lateral sclerosis. Drug-induced yawning is an uncommon clinical condition and yawning in patients with autism or schizophrenia is very rare. The aim of this review is to describe in detail the occurrence of the phenomenon in such conditions, and its’ phenomenology and pathophysiology.