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Mainka T, Balint B, Gövert F, Kurvits L, van Riesen C, Kühn AA, Tijssen MAJ, Lees AJ, Müller-Vahl K, Bhatia KP, Ganos C. The spectrum of involuntary vocalizations in humans: A video atlas. Mov Disord 2019; 34:1774-1791. [PMID: 31651053 DOI: 10.1002/mds.27855] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/22/2019] [Accepted: 08/21/2019] [Indexed: 12/11/2022] Open
Abstract
In clinical practice, involuntary vocalizing behaviors are typically associated with Tourette syndrome and other tic disorders. However, they may also be encountered throughout the entire tenor of neuropsychiatry, movement disorders, and neurodevelopmental syndromes. Importantly, involuntary vocalizing behaviors may often constitute a predominant clinical sign, and, therefore, their early recognition and appropriate classification are necessary to guide diagnosis and treatment. Clinical literature and video-documented cases on the topic are surprisingly scarce. Here, we pooled data from 5 expert centers of movement disorders, with instructive video material to cover the entire range of involuntary vocalizations in humans. Medical literature was also reviewed to document the range of possible etiologies associated with the different types of vocalizing behaviors and to explore treatment options. We propose a phenomenological classification of involuntary vocalizations within different categorical domains, including (1) tics and tic-like vocalizations, (2) vocalizations as part of stereotypies, (3) vocalizations as part of dystonia or chorea, (4) continuous vocalizing behaviors such as groaning or grunting, (5) pathological laughter and crying, (6) vocalizations resembling physiological reflexes, and (7) other vocalizations, for example, those associated with exaggerated startle responses, as part of epilepsy and sleep-related phenomena. We provide comprehensive lists of their associated etiologies, including neurodevelopmental, neurodegenerative, neuroimmunological, and structural causes and clinical clues. We then expand on the pathophysiology of the different vocalizing behaviors and comment on available treatment options. Finally, we present an algorithmic approach that covers the wide range of involuntary vocalizations in humans, with the ultimate goal of improving diagnostic accuracy and guiding appropriate treatment. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Tina Mainka
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Bettina Balint
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK.,Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Felix Gövert
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Lille Kurvits
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Christoph van Riesen
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany.,Department of Neurology, University Medicine Göttingen, Göttingen, Germany
| | - Andrea A Kühn
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Marina A J Tijssen
- Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Andrew J Lees
- Reta Lila Weston Institute of Neurological Studies, UCL, Institute of Neurology, London, UK
| | - Kirsten Müller-Vahl
- Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK
| | - Christos Ganos
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
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Szulczewski MT, Rynkiewicz A. The effects of breathing at a frequency of 0.1 Hz on affective state, the cardiovascular system, and adequacy of ventilation. Psychophysiology 2018; 55:e13221. [PMID: 30010195 DOI: 10.1111/psyp.13221] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 05/30/2018] [Accepted: 05/30/2018] [Indexed: 02/01/2023]
Abstract
The present study aimed to investigate changes induced by breathing at 0.1 Hz in affective state, cardiovascular activity, and adequacy of ventilation as well as the relation between changes in peripheral physiological processes and alteration of affect. Eighty-three participants were randomly assigned to one of three groups: Two groups doing paced breathing at 0.1 Hz, one with and the other without a cover story hiding the goal of the experiment, and, as a control, paced breathing at 0.28 Hz. We measured the effects of breathing at 0.1 Hz on affective state (unpleasant and pleasant arousals), respiratory sinus arrhythmia (RSA), sympathetic control of the heart (preejection period, PEP), and adequacy of ventilation as measured by partial pressure of end-tidal CO2 (PetCO2 ). The use of a cover story did not influence the effects of paced breathing on the study outcomes. In the 0.1 Hz groups, unpleasant arousal decreased only among men. Changes in RSA were not related to changes in affect. Respiratory frequency did not influence PEP. However, changes in PEP were inversely related to changes in pleasant arousal. PetCO2 decreased in all conditions, and a larger drop in PetCO2 predicted a greater decrease in unpleasant arousal. The results obtained corroborate previous findings showing that slow paced breathing may lead to moderate hyperventilation among untrained participants and suggest that hyperventilation during breathing at 0.1 Hz is not deep enough to produce an increase in affective arousal.
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Bendas J, Hummel T, Croy I. Olfactory Function Relates to Sexual Experience in Adults. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1333-1339. [PMID: 29721723 DOI: 10.1007/s10508-018-1203-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 09/13/2017] [Accepted: 03/21/2018] [Indexed: 05/25/2023]
Abstract
The olfactory system contributes significantly to human social behavior and especially to mate choice and empathic functioning. In this context, previous research examining individuals with impaired olfactory function indicated an influence of the sense of smell on different aspects of sexuality. However, the applied samples, methods, and results are diverse and an involvement of confounding factors, such as breathing problems, depression or social insecurity cannot be ruled out. The present study examined the potential correlation between odor threshold in healthy participants and their sexual desire, sexual experience, and sexual performance. In 70 adults (28 male, 42 female; mean age 24.8 ± 4.1 years), odor threshold was assessed using the "Sniffin' Sticks." The participants also responded to a battery of questions on sexual desire (Sexual Desire Inventory), sexual experience (orgasm frequency, perceived pleasantness of sexual activities on a visual analogue scale) as well as sexual performance (frequency of having sex, average duration of sexual intercourse). Odor sensitivity correlated positively with sexual experience: Participants with high olfactory sensitivity reported higher pleasantness of sexual activities. Further, women with high olfactory sensitivity reported a higher frequency of orgasms during sexual intercourse. These findings were exclusively present for sexual experience; no significant correlations were detected for sexual desire or sexual performance. The experience of sexual interactions appears to be enriched by olfactory input. We discuss that the perception of certain body odors may contribute to the concept of sexual pleasure by enhanced recruitment of reward areas.
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Affiliation(s)
- Johanna Bendas
- Department of Psychotherapy and Psychosomatic Medicine, Technische Universität Dresden, Fetscherstraße, 74, 01307, Dresden, Germany.
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
| | - Ilona Croy
- Department of Psychotherapy and Psychosomatic Medicine, Technische Universität Dresden, Fetscherstraße, 74, 01307, Dresden, Germany
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Passie T, Warncke J, Peschel T, Ott U. [Neurotheology: neurobiological models of religious experience]. DER NERVENARZT 2012; 84:283-93. [PMID: 22476509 DOI: 10.1007/s00115-011-3384-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Religions are evolutionary selected social and cultural phenomena. They represent today belief and normative systems on which the main parts of our culture are based. For a long time religions have been seen as mainly originating from a spectrum of religious experiences. These include a broad spectrum of experiences and are astonishingly widespread in the population. The most consistent and transculturally uniform religious experiences are the mystical experiences. Only these (and the prayer experience) have factually been researched in detail neurobiologically. This article presents a review of empirical results and hypothetical approaches to explain mystical religious experiences neurobiologically. Some of the explanatory hypotheses possess logical evidence, some are even supported by neurobiological studies, but all of them have their pitfalls and are at best partially consistent. One important insight from the evidence reviewed here is that there may be a whole array of different neurophysiological conditions which may result in the same core religious mystical experiences.
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Affiliation(s)
- T Passie
- Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Deutschland.
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Charlton BG. A book of ideas collected from Medical Hypotheses: Death can be cured by Roger Dobson. Med Hypotheses 2008; 70:905-9. [PMID: 18280670 DOI: 10.1016/j.mehy.2008.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A new collection of ideas from Medical Hypotheses by Roger Dobson is entitled Death can be cured and 99 other Medical Hypotheses. It consists of humorous summaries of Medical Hypotheses articles from the past 30 years. The book's humour derives mainly from the subject matter, although sometimes also from the 'unconventional' approach of the authors with respect to matters such as evidence, argument or inference. Medical Hypotheses has generated such a lot of apparently- or actually-bizarre ideas because it aims to be open to potentially revolutionary science. The journal's official stance is that more harm is done by a failure to publish one idea that might have been true, than by publishing a dozen ideas that turn out to be false. Bizarre ideas tend to catch attention, and may stimulate a valuable response--even when a paper is mostly-wrong. A paper may be flawed but still contain the germ of an idea that can be elaborated and developed. The journal review process is susceptible to both false positives and false negatives. False positives occur when we publish an idea that is wrong; false negatives occur when we fail to publish an important idea that is right, and a potential scientific breakthrough never happens. False positives are more obvious, since the paper will be ignored, refuted, or fail to be replicated--and often attracts criticism and controversy. Editors may therefore take the more cautious path of avoiding false positives more assiduously than false negatives; however, this policy progressively favours less-ambitious science. Consequently, in Medical Hypotheses the 'set point' of risk is nearer to the false positive end of the spectrum than for most journals - and the publication of many apparently-bizarre papers is a natural consequence of this policy.
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