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Current Cardiology Reports Oct 2023Blood pressure (BP) fluctuations outside of clinic are increasingly recognized for their role in the development of cardiovascular disease, syncope, and premature death... (Review)
Review
PURPOSE OF REVIEW
Blood pressure (BP) fluctuations outside of clinic are increasingly recognized for their role in the development of cardiovascular disease, syncope, and premature death and as a promising target for tailored hypertension treatment. However, current cuff-based BP devices, including home and ambulatory devices, are unable to capture the breadth of BP variability across human activities, experiences, and contexts.
RECENT FINDINGS
Cuffless, wearable BP devices offer the promise of beat-to-beat, continuous, noninvasive measurement of BP during both awake and sleep periods with minimal patient inconvenience. Importantly, cuffless BP devices can characterize BP variability, allowing for the identification of patient-specific triggers of BP surges in the home environment. Unfortunately, the pace of evidence, regulation, and validation testing has lagged behind the pace of innovation and direct consumer marketing. We provide an overview of the available technologies and devices for cuffless BP monitoring, considerations for the calibration and validation of these devices, and the promise and pitfalls of the cuffless BP paradigm.
Topics: Humans; Blood Pressure; Illusions; Blood Pressure Determination; Hypertension; Sphygmomanometers
PubMed: 37688763
DOI: 10.1007/s11886-023-01932-4 -
Journal of the Association For Research... Jun 2024Tinnitus, the perception of sound without a corresponding external sound source, and tinnitus disorder, which is tinnitus with associated suffering, present a... (Review)
Review
Tinnitus, the perception of sound without a corresponding external sound source, and tinnitus disorder, which is tinnitus with associated suffering, present a multifaceted clinical challenge due to its heterogeneity and its incompletely understood pathophysiology and especially due to the limited therapeutic options. In this narrative review, we give an overview on various clinical aspects of tinnitus including its heterogeneity, contributing factors, comorbidities and therapeutic pathways with a specific emphasis on the implications for its pathophysiology and future research directions. Tinnitus exhibits high perceptual variability between affected individuals (heterogeneity) and within affected individuals (temporal variability). Hearing loss emerges as predominant risk factor and the perceived pitch corresponds to areas of hearing loss, supporting the compensatory response theory. Whereas most people who have tinnitus can live a normal life, in 10-20% tinnitus interferes severely with quality of life. These patients suffer frequently from comorbidities such as anxiety, depression or insomnia, acting as both risk factors and consequences. Accordingly, neuroimaging studies demonstrate shared brain networks between tinnitus and stress-related disorders shedding light on the intricate interplay of mental health and tinnitus. The challenge lies in deciphering causative relationships and shared pathophysiological mechanisms. Stress, external sounds, time of day, head movements, distraction, and sleep quality can impact tinnitus perception. Understanding these factors provides insights into the interplay with autonomic, sensory, motor, and cognitive processes. Counselling and cognitive-behavioural therapy demonstrate efficacy in reducing suffering, supporting the involvement of stress and anxiety-related networks. Hearing improvement, especially through cochlear implants, reduces tinnitus and thus indirectly validates the compensatory nature of tinnitus. Brain stimulation techniques can modulate the suffering of tinnitus, presumably by alteration of stress-related brain networks. Continued research is crucial for unravelling the complexities of tinnitus. Progress in management hinges on decoding diverse manifestations, identifying treatment-responsive subtypes, and advancing targeted therapeutic approaches.
Topics: Tinnitus; Humans
PubMed: 38532055
DOI: 10.1007/s10162-024-00939-0 -
Proceedings of the National Academy of... Jul 2023Auditory perception is traditionally conceived as the perception of sounds-a friend's voice, a clap of thunder, a minor chord. However, daily life also seems to present...
Auditory perception is traditionally conceived as the perception of sounds-a friend's voice, a clap of thunder, a minor chord. However, daily life also seems to present us with experiences characterized by the absence of sound-a moment of silence, a gap between thunderclaps, the hush after a musical performance. In these cases, do we positively silence? Or do we just , and merely judge or infer that it is silent? This longstanding question remains controversial in both the philosophy and science of perception, with prominent theories holding that sounds are the only objects of auditory experience and thus that our encounter with silence is cognitive, not perceptual. However, this debate has largely remained theoretical, without a key empirical test. Here, we introduce an empirical approach to this theoretical dispute, presenting experimental evidence that silence can be genuinely perceived (not just cognitively inferred). We ask whether silences can "substitute" for sounds in event-based auditory illusions-empirical signatures of auditory event representation in which auditory events distort perceived duration. Seven experiments introduce three "silence illusions"-the one-silence-is-more illusion, silence-based warping, and the oddball-silence illusion-each adapted from a prominent perceptual illusion previously thought to arise only from sounds. Subjects were immersed in ambient noise interrupted by silences structurally identical to the sounds in the original illusions. In all cases, silences elicited temporal distortions perfectly analogous to the illusions produced by sounds. Our results suggest that silence is truly heard, not merely inferred, introducing a general approach for studying the perception of absence.
Topics: Humans; Illusions; Noise; Sound; Auditory Perception; Hearing; Acoustic Stimulation
PubMed: 37428927
DOI: 10.1073/pnas.2301463120 -
Scientific Reports Jul 2023Chronic pain alters the experience of owning a body and leads to disturbances in bodily perception. We tested whether women with fibromyalgia (FM) are receptive to...
Chronic pain alters the experience of owning a body and leads to disturbances in bodily perception. We tested whether women with fibromyalgia (FM) are receptive to bodily illusions of owning a visible and progressively invisible body in immersive virtual reality (VR), and what modulates this experience. Twenty patients participated in two experimental sessions; each session included two conditions in a counterbalanced order. We found that patients with FM could indeed experience virtual embodiment. Sentiment analysis revealed significantly more positive reactions to the progressively invisible body, yet twice as many patients declared they preferred the illusion of a visible virtual body. A linear mixed model revealed that the strength of embodiment was positively associated with body perception disturbances and negatively associated with FM symptoms intensity. No effect of pain during the VR experience nor interoception awareness on embodiment was found. The results indicated that patients with FM are receptive to virtual bodily illusions and that the impact of the embodiment depends on affective reactions, the level of cognitive body distortions, and the intensity of symptoms. Importantly, there is a large variation among patients which should be considered in future VR-based interventions.
Topics: Humans; Female; Fibromyalgia; Illusions; Virtual Reality; Chronic Pain; Interoception
PubMed: 37400503
DOI: 10.1038/s41598-023-36861-3 -
Psychological Medicine Nov 2023Cannabis is well established to impact affective states, emotion and perceptual processing, primarily through its interactions with the endocannabinoid system. While... (Review)
Review
Cannabis is well established to impact affective states, emotion and perceptual processing, primarily through its interactions with the endocannabinoid system. While cannabis use is quite prevalent in many individuals afflicted with psychiatric illnesses, there is considerable controversy as to whether cannabis may worsen these conditions or provide some form of therapeutic benefit. The development of pharmacological agents which interact with components of the endocannabinoid system in more localized and discrete ways then via phytocannabinoids found in cannabis, has allowed the investigation if direct targeting of the endocannabinoid system itself may represent a novel approach to treat psychiatric illness without the potential untoward side effects associated with cannabis. Herein we review the current body of literature regarding the various pharmacological tools that have been developed to target the endocannabinoid system, their impact in preclinical models of psychiatric illness and the recent data emerging of their utilization in clinical trials for psychiatric illnesses, with a specific focus on substance use disorders, trauma-related disorders, and autism. We highlight several candidate drugs which target endocannabinoid function, particularly inhibitors of endocannabinoid metabolism or modulators of cannabinoid receptor signaling, which have emerged as potential candidates for the treatment of psychiatric conditions, particularly substance use disorder, anxiety and trauma-related disorders and autism spectrum disorders. Although there needs to be ongoing clinical work to establish the potential utility of endocannabinoid-based drugs for the treatment of psychiatric illnesses, the current data available is quite promising and shows indications of several potential candidate diseases which may benefit from this approach.
Topics: Humans; Endocannabinoids; Mental Disorders; Anxiety; Anxiety Disorders; Cannabis; Cannabinoid Receptor Agonists; Hallucinogens
PubMed: 37671673
DOI: 10.1017/S0033291723002465 -
Journal of Vision Sep 2023Binocular rivalry is a widely used tool in sensory and cognitive neuroscience to investigate different aspects of vision and cognition. The dynamics of binocular rivalry...
Binocular rivalry is a widely used tool in sensory and cognitive neuroscience to investigate different aspects of vision and cognition. The dynamics of binocular rivalry (e.g., duration of perceptual dominance phases and mixed percept proportions) differ across individuals; based on rivalry dynamics, it is also possible to calculate an index of ocular dominance (by comparing the perceptual dominance of the images in the two eyes). In this study, we investigated the reliability of binocular rivalry dynamics using different methods for dichoptic stimulation and different rivalry stimuli. For the three main indices we defined (ocular dominance, phase durations and mixed percept proportions), we found a high test-retest reliability across sessions. Moreover, the test-retest reliability of the ocular dominance index was predictable from its internal consistency, supporting its stability over time. Phase durations and mixed percept proportions, in contrast, had worse test-retest reliability than expected based on internal consistency, indicating that these parameters are susceptible to state-dependent changes. Our results support the use of the ocular dominance index and binocular rivalry in the measurement of sensory eye dominance and its plasticity, but advise caution when investigating the association between phase durations or mixed percepts and stable characteristics like psychological traits or disorders.
Topics: Humans; Reproducibility of Results; Cognition; Dominance, Ocular; Eye
PubMed: 37676671
DOI: 10.1167/jov.23.10.5 -
Psychonomic Bulletin & Review Apr 2024Across the millennia, and across a range of disciplines, there has been a widespread desire to connect, or translate between, the senses in a manner that is meaningful,... (Review)
Review
Across the millennia, and across a range of disciplines, there has been a widespread desire to connect, or translate between, the senses in a manner that is meaningful, rather than arbitrary. Early examples were often inspired by the vivid, yet mostly idiosyncratic, crossmodal matches expressed by synaesthetes, often exploited for aesthetic purposes by writers, artists, and composers. A separate approach comes from those academic commentators who have attempted to translate between structurally similar dimensions of perceptual experience (such as pitch and colour). However, neither approach has succeeded in delivering consensually agreed crossmodal matches. As such, an alternative approach to sensory translation is needed. In this narrative historical review, focusing on the translation between audition and vision, we attempt to shed light on the topic by addressing the following three questions: (1) How is the topic of sensory translation related to synaesthesia, multisensory integration, and crossmodal associations? (2) Are there common processing mechanisms across the senses that can help to guarantee the success of sensory translation, or, rather, is mapping among the senses mediated by allegedly universal (e.g., amodal) stimulus dimensions? (3) Is the term 'translation' in the context of cross-sensory mappings used metaphorically or literally? Given the general mechanisms and concepts discussed throughout the review, the answers we come to regarding the nature of audio-visual translation are likely to apply to the translation between other perhaps less-frequently studied modality pairings as well.
Topics: Humans; Visual Perception; Auditory Perception; Synesthesia; History, 20th Century
PubMed: 37803233
DOI: 10.3758/s13423-023-02343-w -
Cureus Jan 2024Room tilt illusion (RTI) is a rare and transient perceptual disturbance in which an individual perceives their surroundings as having been rotated or tilted, usually at...
Room tilt illusion (RTI) is a rare and transient perceptual disturbance in which an individual perceives their surroundings as having been rotated or tilted, usually at 90 or 180 degrees. Primarily linked with vestibular disorders and neurological lesions, this report details the only reported occurrence of the RTI phenomena in nortriptyline use for treatment-refractory depression. The patient developed RTI six days after starting the medication and the disturbance resolved after medication cessation. Although the mechanism behind such a phenomenon with medication use has not been elucidated, its etiology may rest on the effect of tricyclic antidepressants on the vestibulo-thalamo-cortical system and visual-vestibular integration. Clinicians should be aware of the potential for such a medication-induced perceptual disturbance, especially in the workup for more serious etiologies in elderly patients with co-morbidities.
PubMed: 38344625
DOI: 10.7759/cureus.52101 -
Journal of Speech, Language, and... Oct 2023As evidenced by perceptual learning studies involving adult listeners and speakers with dysarthria, adaptation to dysarthric speech is driven by signal predictability...
PURPOSE
As evidenced by perceptual learning studies involving adult listeners and speakers with dysarthria, adaptation to dysarthric speech is driven by signal predictability (speaker property) and a flexible speech perception system (listener property). Here, we extend adaptation investigations to adolescent populations and examine whether adult and adolescent listeners can learn to better understand an adolescent speaker with dysarthria.
METHOD
Classified by developmental stage, adult ( = 42) and adolescent ( = 40) listeners completed a three-phase perceptual learning protocol (pretest, familiarization, and posttest). During pretest and posttest, all listeners transcribed speech produced by a 13-year-old adolescent with spastic dysarthria associated with cerebral palsy. During familiarization, half of the adult and adolescent listeners engaged in structured familiarization (audio and lexical feedback) with the speech of the adolescent speaker with dysarthria; and the other half, with the speech of a neurotypical adolescent speaker (control).
RESULTS
Intelligibility scores increased from pretest to posttest for all listeners. However, listeners who received dysarthria familiarization achieved greater intelligibility improvements than those who received control familiarization. Furthermore, there was a significant effect of developmental stage, where the adults achieved greater intelligibility improvements relative to the adolescents.
CONCLUSIONS
This study provides the first tranche of evidence that adolescent dysarthric speech is learnable-a finding that holds even for adolescent listeners whose speech perception systems are not yet fully developed. Given the formative role that social interactions play during adolescence, these findings of improved intelligibility afford important clinical implications.
Topics: Adult; Humans; Adolescent; Speech Intelligibility; Dysarthria; Learning; Cognition; Speech Perception
PubMed: 37616225
DOI: 10.1044/2023_JSLHR-23-00231