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Govindaraj R, Naik SS, Mehta UM, Sharma M, Varambally S, Gangadhar BN. Yoga therapy for social cognition in schizophrenia: An experimental medicine-based randomized controlled trial. Asian J Psychiatr 2021; 62:102731. [PMID: 34098192 DOI: 10.1016/j.ajp.2021.102731] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/20/2021] [Accepted: 05/30/2021] [Indexed: 12/12/2022]
Abstract
Negative symptoms and cognitive deficits are difficult-to-treat symptoms of schizophrenia. In this single blind randomized controlled study, we compared change in social cognitive performance in persons with Schizophrenia (PWS) (as per DSM-5), after 6 weeks of yoga intervention with a waitlist control group. We also examined changes in putative Mirror Neuron System (MNS) activity measured by Transcranial Magnetic Stimulation (TMS) in a subset of sample (n = 30). 51 PWS stabilized on antipsychotic medication for at least 6 weeks, were assigned to add-on yoga therapy (YT) (n = 26) or waitlist (WL) (n = 25). Subjects in the YT group received add-on yoga therapy (20 sessions in 6 weeks). Both the groups continued their standard treatment and were assessed at baseline and after 6 weeks for social cognition, clinical symptoms and social disability. RM-ANOVA showed significant interaction between time and group for social cognition composite score (SCCS) (F = 42.09 [1,44], P < 0.001); negative symptoms (SANS) (F = 74.91 [1,45], P < 0.001); positive symptoms (SAPS) (F = 16.05 [1,45], P < 0.001) and social disability (GSDS) (F = 29.91 [1,46], P < 0.001). MNS activity had increased after 6 weeks in both groups but not of statistical significance. This study demonstrates that 6 weeks of add-on yoga therapy could improve social cognition in PWS compared to waitlist control subjects. However, the change in social cognition was not associated with a change in the putative MNS-activity. It necessiatates further studies to investigate the mechanistic processes of yoga and replicate these observations in a larger sample.
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Affiliation(s)
- Ramajayam Govindaraj
- Centre for Consciousness Studies, Department of Neurophysiology, National Institute of Mental Health & Neurosciences, Bengaluru, India.
| | - Shalini S Naik
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, India.
| | - Urvakhsh M Mehta
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, India.
| | - Manjunath Sharma
- Anvesana Research Laboratory, S-VYASA University, Bengaluru, India.
| | - Shivarama Varambally
- Department of Integrative Medicine, National Institute of Mental Health & Neurosciences, Bengaluru, India.
| | - B N Gangadhar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Bengaluru, India.
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Caine JA, Klein B, Edwards SL. The Impact of a Novel Mimicry Task for Increasing Emotion Recognition in Adults with Autism Spectrum Disorder and Alexithymia: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e24543. [PMID: 34170257 PMCID: PMC8386358 DOI: 10.2196/24543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/15/2020] [Accepted: 02/24/2021] [Indexed: 11/17/2022] Open
Abstract
Background Impaired facial emotion expression recognition (FEER) has typically been considered a correlate of autism spectrum disorder (ASD). Now, the alexithymia hypothesis is suggesting that this emotion processing problem is instead related to alexithymia, which frequently co-occurs with ASD. By combining predictive coding theories of ASD and simulation theories of emotion recognition, it is suggested that facial mimicry may improve the training of FEER in ASD and alexithymia. Objective This study aims to evaluate a novel mimicry task to improve FEER in adults with and without ASD and alexithymia. Additionally, this study will aim to determine the contributions of alexithymia and ASD to FEER ability and assess which of these 2 populations benefit from this training task. Methods Recruitment will primarily take place through an ASD community group with emphasis put on snowball recruiting. Included will be 64 consenting adults equally divided between participants without an ASD and participants with an ASD. Participants will be screened online using the Kessler Psychological Distress Scale (K-10; cut-off score of 22), Autism Spectrum Quotient (AQ-10), and Toronto Alexithymia Scale (TAS-20) followed by a clinical interview with a provisional psychologist at the Federation University psychology clinic. The clinical interview will include assessment of ability, anxiety, and depression as well as discussion of past ASD diagnosis and confirmatory administration of the Autism Mental Status Exam (AMSE). Following the clinical interview, the participant will complete the Bermond-Vorst Alexithymia Questionnaire (BVAQ) and then undertake a baseline assessment of FEER. Consenting participants will then be assigned using a permuted blocked randomization method into either the control task condition or the mimicry task condition. A brief measure of satisfaction of the task and a debriefing session will conclude the study. Results The study has Federation University Human Research Ethics Committee approval and is registered with the Australian New Zealand Clinical Trials. Participant recruitment is predicted to begin in the third quarter of 2021. Conclusions This study will be the first to evaluate the use of a novel facial mimicry task condition to increase FEER in adults with ASD and alexithymia. If efficacious, this task could prove useful as a cost-effective adjunct intervention that could be used at home and thus remove barriers to entry. This study will also explore the unique effectiveness of this task in people without an ASD, with an ASD, and with alexithymia. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN12619000705189p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377455 International Registered Report Identifier (IRRID) PRR1-10.2196/24543
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Affiliation(s)
- Joshua A Caine
- School of Science Psychology and Sport, Federation University Australia, Ballarat, Australia.,Deputy Vice Chancellor of Research & Innovation Portfolio, Federation University Australia, Ballarat, Australia.,Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia.,Biopsychosocial and eHealth Research & Innovation, Federation University Australia, Ballarat, Australia
| | - Britt Klein
- Deputy Vice Chancellor of Research & Innovation Portfolio, Federation University Australia, Ballarat, Australia.,Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia.,Biopsychosocial and eHealth Research & Innovation, Federation University Australia, Ballarat, Australia
| | - Stephen L Edwards
- School of Science Psychology and Sport, Federation University Australia, Ballarat, Australia.,Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia.,Biopsychosocial and eHealth Research & Innovation, Federation University Australia, Ballarat, Australia
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Carpente J, Casenhiser DM, Kelliher M, Mulholland J, Sluder HL, Crean A, Cerruto A. The impact of imitation on engagement in minimally verbal children with autism during improvisational music therapy. NORDIC JOURNAL OF MUSIC THERAPY 2021. [DOI: 10.1080/08098131.2021.1924843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- John Carpente
- Rebecca Center for Music Therapy at Molloy College, Rockville Centre, NY, USA
| | - Devin M. Casenhiser
- Department of Audiology & Speech Pathology, University of Tennessee Health Science Center, Knoxville, TN, USA
| | - Michael Kelliher
- Rebecca Center for Music Therapy at Molloy College, Rockville Centre, NY, USA
| | - Jill Mulholland
- Rebecca Center for Music Therapy at Molloy College, Rockville Centre, NY, USA
| | - H. Logan Sluder
- Department of Audiology & Speech Pathology, University of Tennessee Health Science Center, Knoxville, TN, USA
| | - Anne Crean
- Rebecca Center for Music Therapy at Molloy College, Rockville Centre, NY, USA
| | - Audra Cerruto
- Rebecca Center for Music Therapy at Molloy College, Rockville Centre, NY, USA
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Filippa M, Monaci MG, Young S, Grandjean D, Nuti G, Nadel J. Shall We Play the Same? Pedagogical Perspectives on Infants’ and Children’s Imitation of Musical Gestures. Front Psychol 2020; 11:1087. [PMID: 32581943 PMCID: PMC7283546 DOI: 10.3389/fpsyg.2020.01087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 04/28/2020] [Indexed: 11/13/2022] Open
Abstract
Imitation, both gestural and vocal, has been acknowledged to be at the origin of human communication (Donald, 1991). Music is often considered to be the first means of communication of emotion via both vocal and gestural synchronization (Malloch, 1999; Malloch and Trevarthen, 2009). Instrumental music is part of the human heritage for more than 35,000 years before our era (Aimé et al., 2020). However, very little is known about the acquisition of gestures that produce sounds (i.e., musical gestures) and their role in the development of music and musicality. In the present paper, we propose that studying early synchronous imitation of musical gestures is essential both for investigating the development of the early action–perception system and for outlining early music interventions during infancy. We designed double musical objects which can be used in preschool music education for prompting synchronic imitation of musical gestures between adult and child, and between dyads of infants. We conclude by proposing a novel pedagogical perspective in music education for the early years which links the privileged orientation of infants and children towards sound discoveries with the development of perception-action coupling via imitation of musical gestures.
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Affiliation(s)
- Manuela Filippa
- Neuroscience of Emotion and Affective Dynamics Laboratory, Department of Psychology and Educational Sciences, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, University of Geneva, Geneva, Switzerland
- Department of Social Sciences, University of Valle d’Aosta, Aosta, Italy
- *Correspondence: Manuela Filippa,
| | | | - Susan Young
- University of Roehampton London, London, United Kingdom
| | - Didier Grandjean
- Neuroscience of Emotion and Affective Dynamics Laboratory, Department of Psychology and Educational Sciences, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Gianni Nuti
- Department of Social Sciences, University of Valle d’Aosta, Aosta, Italy
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Ramseyer F, Ebert A, Roser P, Edel M, Tschacher W, Brüne M. Exploring nonverbal synchrony in borderline personality disorder: A double‐blind placebo‐controlled study using oxytocin. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2019; 59:186-207. [DOI: 10.1111/bjc.12240] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/27/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Fabian Ramseyer
- Department of Clinical Psychology and Psychotherapy Institute of Psychology University of Bern Switzerland
| | - Andreas Ebert
- Division of Social Neuropsychiatry and Evolutionary Medicine Department of Psychiatry, Psychotherapy and Preventive Medicine LWL University Hospital BochumRuhr‐University Bochum Germany
| | - Patrik Roser
- Centre for Addiction Disorders Psychiatric Hospital Königsfelden Psychiatric Services Aargau Academic Hospital of the University of Zurich Switzerland
| | | | - Wolfgang Tschacher
- Department of Experimental Psychology University Hospital of Psychiatry and Psychotherapy University of Bern Switzerland
| | - Martin Brüne
- Division of Social Neuropsychiatry and Evolutionary Medicine Department of Psychiatry, Psychotherapy and Preventive Medicine LWL University Hospital BochumRuhr‐University Bochum Germany
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Yoga: Balancing the excitation-inhibition equilibrium in psychiatric disorders. PROGRESS IN BRAIN RESEARCH 2019; 244:387-413. [PMID: 30732846 DOI: 10.1016/bs.pbr.2018.10.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Social behavioral disturbances are central to most psychiatric disorders. A disequilibrium within the cortical excitatory and inhibitory neurotransmitter systems underlies these deficits. Gamma-aminobutyric acid (GABA) and glutamate are the most abundant excitatory and inhibitory neurotransmitters in the brain that contribute to this equilibrium. Several contemporary therapies used in treating psychiatric disorders, regulate this GABA-glutamate balance. Yoga has been studied as an adjuvant treatment across a broad range of psychiatric disorders and is shown to have short-term therapeutic gains. Emerging evidence from recent clinical in vivo experiments suggests that yoga improves GABA-mediated cortical-inhibitory tone and enhances peripheral oxytocin levels. This is likely to have a more controlled downstream response of the hypothalamo-pituitary-adrenal system by means of reduced cortisol release and hence a blunted sympathetic response to stress. Animal and early fetal developmental studies suggest an inter-dependent role of oxytocin and GABA in regulating social behaviors. In keeping with these observations, we propose an integrated neurobiological model to study the mechanisms of therapeutic benefits with yoga. Apart from providing a neuroscientific basis for applying a traditional system of practice in the clinical setting, this model can be used as a framework for studying yoga mechanisms in future clinical trials.
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Abstract
The neuropeptide oxytocin (OT) has emerged as a potent modulator of diverse aspects of interpersonal relationships. OT appears to work in close interaction with several other neurotransmitter networks, including the dopaminergic reward circuit, and to be dependent on sex-specific hormonal influences. In this chapter, we focus on four main domains of OT and interpersonal relationships, including (1) the protective effect of OT on an individual's ability to withstand stress (i.e., stress buffering), (2) the effect of OT on emotion recognition and empathy, (3) OT's ability to enhance social synchrony and cooperation among individuals, and (4) the effect of OT on an individual's perception of social touch. We then illustrate the connection between OT and loneliness while grieving the loss of a loved one. We finish by discussing the clinical potential of OT, focusing on its potential role as an adjunct to psychotherapy, its enhancement through sex-specific hormonal influences, and the difficulties that present themselves when considering OT as a therapy. Overall, we argue that OT continues to hold strong therapeutic promise, but that it is strongly dependent on internal and external influences, for instance the patient's personal past experiences and interaction with the therapist, in order to provide the best possible therapy.
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Mehta UM, Keshavan MS, Gangadhar BN. Bridging the schism of schizophrenia through yoga-Review of putative mechanisms. Int Rev Psychiatry 2016; 28:254-64. [PMID: 27187680 DOI: 10.1080/09540261.2016.1176905] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Schizophrenia patients experience a 'disconnect' at multiple levels-neuronal networks, mental processes, and interpersonal relationships. The resultant poor quality-of-life and functional disability are related to the persistent cognitive deficits and negative symptoms, which are rather resistant to conventional antipsychotic medications. Yoga has emerged as an important therapeutic intervention to improve quality-of-life in schizophrenia. Recent preliminary evidence suggests that effects of yoga on cognitive and negative symptoms may drive this benefit. This study attempts to integrate evidence from neuroscience-based research, which focuses on the neuroplasticity-harnessing effects of yoga to bridge the schizophrenia connectopathy. In an overarching model to study putative neurobiological mechanisms that drive therapeutic effects of yoga, it is proposed that (a) various styles of meditation may help in strengthening the lateral and medial prefrontal brain networks, thus improving neurocognition and mentalizing abilities, and (b) learning and performing co-ordinated physical postures with a teacher facilitates imitation and the process of being imitated, which can improve social cognition and empathy through reinforcement of the premotor and parietal mirror neuron system. Oxytocin may play a role in mediating these processes, leading to better social connectedness and social outcomes. Clinical and heuristic implications of this model are further discussed.
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Affiliation(s)
- Urvakhsh Meherwan Mehta
- a Department of Psychiatry , National Institute of Mental Health & Neurosciences (NIMHANS) , Bengaluru , India
| | - Matcheri S Keshavan
- b Department of Psychiatry , Beth Israel Deaconess Medical Center and Harvard Medical School , Boston , MA , USA
| | - Bangalore N Gangadhar
- a Department of Psychiatry , National Institute of Mental Health & Neurosciences (NIMHANS) , Bengaluru , India
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