Spinal cord lesions, peripheral feedback, and intensities of emotional feelings

Massive body-brain disconnection consequent to spinal cord injuries drives profound changes in higher-order cognitive and emotional functions: A PRISMA scoping review

Spinal cord injury (SCI) leads to a massive disconnection between the brain and the body parts below the lesion level representing a unique opportunity to explore how the body influences a person's mental life. We performed a systematic scoping review of 59 studies on higher-order cognitive and emotional changes after SCI. The results suggest that fluid abilities (e.g. attention, executive functions) and emotional regulation (e.g. emotional reactivity and discrimination) are impaired in people with SCI, with progressive deterioration over time. Although not systematically explored, the factors that are directly (e.g. the severity and level of the lesion) and indirectly associated (e.g. blood pressure, sleeping disorders, medication) with the damage may play a role in these deficits. The inconsistency which was found in the results may derive from the various methods used and the heterogeneity of samples (i.e. the lesion completeness, the time interval since lesion onset). Future studies which are specifically controlled for methods, clinical and socio-cultural dimensions are needed to better understand the role of the body in cognition.

Emotion, motivation, decision-making, the orbitofrontal cortex, anterior cingulate cortex, and the amygdala

The orbitofrontal cortex and amygdala are involved in emotion and in motivation, but the relationship between these functions performed by these brain structures is not clear. To address this, a unified theory of emotion and motivation is described in which motivational states are states in which instrumental goal-directed actions are performed to obtain rewards or avoid punishers, and emotional states are states that are elicited when the reward or punisher is or is not received. This greatly simplifies our understanding of emotion and motivation, for the same set of genes and associated brain systems can define the primary or unlearned rewards and punishers such as sweet taste or pain. Recent evidence on the connectivity of human brain systems involved in emotion and motivation indicates that the orbitofrontal cortex is involved in reward value and experienced emotion with outputs to cortical regions including those involved in language, and is a key brain region involved in depression and the associated changes in motivation. The amygdala has weak effective connectivity back to the cortex in humans, and is implicated in brainstem-mediated responses to stimuli such as freezing and autonomic activity, rather than in declarative emotion. The anterior cingulate cortex is involved in learning actions to obtain rewards, and with the orbitofrontal cortex and ventromedial prefrontal cortex in providing the goals for navigation and in reward-related effects on memory consolidation mediated partly via the cholinergic system.

From Wide Cognition to Mechanisms: A Silent Revolution

In this paper, we argue that several recent ‘wide’ perspectives on cognition (embodied, embedded, extended, enactive, and distributed) are only partially relevant to the study of cognition. While these wide accounts override traditional methodological individualism, the study of cognition has already progressed beyond these proposed perspectives toward building integrated explanations of the mechanisms involved, including not only internal submechanisms but also interactions with others, groups, cognitive artifacts, and their environment. Wide perspectives are essentially research heuristics for building mechanistic explanations. The claim is substantiated with reference to recent developments in the study of “mindreading” and debates on emotions. We argue that the current practice in cognitive (neuro)science has undergone, in effect, a silent mechanistic revolution, and has turned from initial binary oppositions and abstract proposals toward the integration of wide perspectives with the rest of the cognitive (neuro)sciences.

Biographical disruption and the experience of loss following a spinal cord injury: an interpretative phenomenological analysis

Individual in-depth interviews with eight people who had experienced a total spinal cord injury were conducted, focussing on the experience of living with a spinal cord injury. The interviews were transcribed verbatim and were analysed for recurrent themes using Interpretative Phenomenological Analysis (IPA). Here we present three inter-related recurrent themes: 'Loss of control'; 'Loss of independence' and 'Loss of identity'. Participants reported an ongoing sense of loss, characterised largely by a diminishing sense of personal control. This loss of personal control manifested itself in incontinence, emotion and loss of movement. Helplessness and embarrassment were common responses. A loss of independence was associated with incontinence but also with a loss of spontaneity. A loss of identity ensued and participants reported feeling 'invisible'. The findings are discussed in relation to both extant spinal cord literature and chronic health literature. Recommendations for future research are suggested.

A Behavior Analytic Interpretation of Alexithymia

Alexithymia is a term used to describe individuals who seem unable to experience or at least describe emotions. This paper offers a theoretical interpretation of alexithymia from a radical behaviorist perspective. While there have been attempts to explain the etiology of alexithymia, the current analysis is unique in that it provides direct treatment implications. The pragmatic analysis described focuses on the verbal behavior of individuals rather than looking "inside" for explanations. This is supported by a review of experimental research that has failed to find consistencies among alexithymic individuals' physiological responding. Descriptions of the various discriminative and consequential stimulus conditions involved in the complex learning histories of individuals that could result in an alexithymic presentation are provided. This analysis helps situate the alexithymia construct in a broader behavior analytic understanding of emotions. Finally this paper outlines implications for assessment and treatment, which involve influencing discriminative and consequential interpersonal stimulus conditions to shape verbal behavior about emotions.

Bodily Influences on Emotional Feelings: Accumulating Evidence and Extensions of William James’s Theory of Emotion

William James’s theory of emotion has been controversial since its inception, and a basic analysis of Cannon’s critique is provided. Research on the impact of facial expressions, expressive behaviors, and visceral responses on emotional feelings are each reviewed. A good deal of evidence supports James’s theory that these types of bodily feedback, along with perceptions of situational cues, are each important parts of emotional feelings. Extensions to James’s theory are also reviewed, including evidence of individual differences in the effect of bodily responses on emotional experience.

Examining the effect of spinal cord injury on emotional awareness, expressivity and memory for emotional material

The prevailing view on the effects of spinal cord injury (SCI) on emotion is that it dampens emotional experience due to a loss of peripheral bodily feedback, with the higher the lesion on the spinal cord the greater the reduction in the intensity of emotional experience. This view persists despite many studies showing an absence of such an emotional impairment in people with SCI. This study specifically aimed to investigate whether total cervical-6 spinal cord transection (i) reduces emotional expressivity and emotional awareness (ii) impairs memory for emotional material. The study contained three groups: 24 patients with SCI, 20 orthopaedic injury control (OIC) patients and 20 young adult controls. A mixed factor design was employed to examine between group and within subject differences. Participants completed the Levels of Emotional Awareness Scale (LEAS), the Berkeley Expressivity Questionnaire (BEQ), and viewed an emotionally arousing slide presentation. Thirty minutes post viewing, participants completed memory tests for the presentation. SCI patients reported greater present levels of emotional expressivity compared with perceived levels prior to their injuries. SCI and OIC groups did not differ on any of the emotional awareness variables. There was also no evidence that SCI leads to impairment in memory for emotional events. This study's findings contradict the mainstream view in the cognitive neuroscience of emotion that SCI dampens emotional experience.

Emotional and autonomic consequences of spinal cord injury explored using functional brain imaging

In health, emotions are integrated with autonomic bodily responses. Emotional stimuli elicit changes in somatic (including autonomic) bodily states, which feedback to influence the expression of emotional feelings. In patients with spinal cord injury (SCI), this integration of emotion and bodily arousal is partially disrupted, impairing both efferent generation of sympathetic responses and afferent sensory feedback of visceral state via the spinal cord. A number of theoretical accounts of emotion predict emotional deficits in SCI patients, particularly at the level of emotional feelings, yet evidence for such a deficit is equivocal. We used functional MRI (fMRI) and a basic emotional learning paradigm to investigate the expression of emotion-related brain activity consequent upon SCI. We scanned seven SCI patients and seven healthy controls during an aversive fear conditioning task. Subjects viewed randomized presentations of four angry faces. One of the faces (CS + arm) was associated with delivery of electrical shock to the upper arm on 50% of trials. This shock was painful to all subjects. A face of the same gender acted as a 'safe' control stimulus (CS - arm). In both control subjects and SCI patients, painful cutaneous stimulation of the arm evoked enhanced activity within components of a central pain matrix, including dorsal anterior cingulate, right insula and medial temporal lobe. However, SCI patients differed from controls in conditioning-related brain activity. SCI patients showed a relative enhancement of activity within dorsal anterior cingulate, periaqueductal grey matter (PAG) and superior temporal gyrus. Conversely, SCI patients showed relative attenuation of activity in subgenual cingulate, ventromedial prefrontal and posterior cingulate cortices to threat of painful arm stimulation (CS + arm > CS - arm). Our findings provide evidence for differences in emotion-related brain activity in SCI patients. We suggest that the observed functional abnormalities including enhanced anterior cingulate and PAG reflect central sensitization of the pain matrix, while decreased subgenual cingulate activity may represent a substrate underlying affective vulnerability in SCI patients consequent upon perturbation of autonomic control and afferent visceral representation. Together these observations may account for motivational and affective sequelae of SCI in some individuals.

Revisiting the James versus Cannon debate on emotion: startle and autonomic modulation in patients with spinal cord injuries

James' hypothesis that impaired peripheral physiology in patients with spinal cord injuries (SCI) impairs emotional processing, as manifested in the modulation of physiological responses and in the subjective component of emotions, was examined in the present study. A pilot study confirmed the utility of Lang's picture viewing paradigm in a group of 78 students using the Spanish norms of the International Affective Picture System. In the main study, 19 patients with SCI and 19 well controls matched for sex, age and education were examined. Results showed: (1) no differences between SCI and control participants in the valence and arousal ratings of the pictures; (2) similar heart rate modulation in both groups, i.e. the unpleasant pictures produced greater deceleration than the pleasant ones; and (3) no decrease in emotional experience in the SCI group compared with the control group. The implications of the results for the James versus Cannon controversy on the theory of emotions are discussed.

Emotion, plasticity, context, and regulation: perspectives from affective neuroscience

The authors present an overview of the neural bases of emotion. They underscore the role of the prefrontal cortex (PFC) and amygdala in 2 broad approach- and withdrawal-related emotion systems. Components and measures of affective style are identified. Emphasis is given to affective chronometry and a role for the PFC in this process is proposed. Plasticity in the central circuitry of emotion is considered, and implications of data showing experience-induced changes in the hippocampus for understanding psychopathology and stress-related symptoms are discussed. Two key forms of affective plasticity are described--context and regulation. A role for the hippocampus in context-dependent normal and dysfunctional emotional responding is proposed. Finally, implications of these data for understanding the impact on neural circuitry of interventions to promote positive affect and on mechanisms that govern health and disease are considered.