Bilateral electrodermal activity and asymmetric responses in normal healthy individuals

Background: Electrodermal activity (EDA) or galvanic skin response (GSR) is the change in the electrical properties of the skin which is used to measure the sympathetic activity and response. When a painful stimulus is applied, it elicits a sympathetic response by increasing sweat gland activity that, in turn, increases the skin conductance. Central nervous system plays important role in regulating sympathetic activity. Aims and Objectives: The objectives of this study were as follows: (1) To evaluate the electrodermal responses (EDR) in dominant and non-dominant hand; (2) to compare the EDRs in dominant and non-dominant hand. Materials and Methods: The study was done among MBBS students of age 18–23 years in physiology research laboratory and EDA values were analyzed using BIOCHART software (version1.0) through physiograph. EDA was recorded using skin surface electrodes. Pulse and blood pressure were monitored before and after immersion in cold water. Baseline recording, recording after immersion of hand in cold water, and recovery recording of GSR were noted in dominant and non-dominant hands. Results: The mean GSR, baseline value, and the GSR after cold stimulation were significantly more in non-dominant hand compared to dominant hand. Conclusion: Our findings show an increased sympathetic activity in non-dominant hand in response to cold stimulation compared to dominant hand.

The intolerance of uncertainty on state worry and state anxiety of college students with medium and low trait anxiety / 中华行为医学与脑科学杂志

Objective:To investigate the effect of intolerance of uncertainty (IU) on state worry, state anxiety, and galvanic skin response in college students with medium and low trait anxiety.Methods:The trait anxiety inventory (TAI) and the intolerance of uncertainty scale (IUS) were used to investigate 1 378 college students in Beijing. A total of 537 individuals with medium or low trait anxiety (TAI score ≤54) were selected, from which high IU individuals (IUS score ≤58) and low IU individuals (IUS score > 58) were selected and allocated to uncertain group ( n=28) and certain group ( n=28) according to gender, age, education level and IU score. The modified NPU paradigm task, the penn state worry questionnaire(PSWQ)and the brief state anxiety measurement(BSAM) were used to assess the subjects' worry and anxiety.The galvanic skin response of individuals completing the NPU paradigm task was recorded.SPSS 26.0 was used for a two factor analysis of variance (classification: high IU, low IU; group: uncertain group, certain group). Results:The results of the two factor analysis of variance showed that the interaction between individual state anxiety classification and group was not significant( F(1, 55)=0.05, P>0.05, η2=2.16). The main effect of classification was significant( F(1, 55)=24.17, P<0.05, η2=1143.01). The anxiety level of individuals with high IU was significantly lower than that of individuals with low IU( P<0.05). The group main effect was not significant( F(1, 55)=0.03, P>0.05, η2=1.45), and there was no significant difference between the uncertainty group and the certainty group in terms of worry( P>0.05). The interaction between individual state anxiety classification and group was significant ( F(1, 55)=4.38, P<0.05, η2=3.02). The simple analysis results showed that in the uncertain group, the state anxiety of individuals with high IU was significantly lower than that of individuals with low IU ( P<0.05). In the certain group, there was no significant difference in state anxiety between individuals with high and low IU ( P>0.05). The interaction between individual galvanic skin response classification and group was not significant ( F(1, 55)=0.03, P>0.05, η2=0.00). The classification main effect was not significant( F(1, 55)=0.07, P>0.05, η2=0.00), and there was no significant difference in skin electrical activity between individuals with high and low IU ( P>0.05). But the main effect of the group was significant( F(1, 55)=4.86, P<0.05, η2=0.03). The skin electrical activity of the uncertain group was higher than that of the certain group( P<0.05). Conclusion:In the college students with medium and low trait anxiety, IU is an effective predictor of individual state worry and state anxiety under uncertain conditions.

Physiological methods as indexes of listening effort measurement: an integrative literature review / Métodos fisiológicos como índices de mensuração do esforço auditivo: uma revisão integrativa da literatura

ABSTRACT Purpose: to review the scientific literature and present existing instruments and methods for the objective assessment of the listening effort in normal hearing individuals worldwide. Methods: a literature integrative review whose purpose was to gather and summarize the scientific knowledge regarding the objective methods theme for measuring the listening effort, developed through the search of articles in specialized national and international journals, in the English and Portuguese languages, available in the databases: PUBMED, Cochrane Library, LILACS and SCIELO. Results: 18 articles which used physiological methods to measure the listening effort in individuals with normal hearing were reviewed. The main findings described in those articles refer to the author(s) and purpose(s) of the research, country where the research was conducted, casuistry, physiological method used and results. Conclusion: there is no consensus among the researchers about the best physiological method to measure this parameter, that is, this effort in the speech perception tasks, although the level of skin conductance is considered the most accurate measure to date.

RESUMO Objetivo: revisar a literatura científica e apresentar os instrumentos e métodos existentes para a avaliação objetiva do esforço auditivo em indivíduos normo-ouvintes no cenário mundial. Métodos: esta foi uma revisão integrativa de literatura cujo intuito foi reunir e resumir o conhecimento científico a respeito da temática métodos objetivos para mensuração do esforço auditivo, desenvolvida por meio da busca de artigos em periódicos especializados, nacionais e internacionais, nos idiomas inglês e português, disponíveis nas bases de dados: PUBMED, Biblioteca Cochrane, LILACS e SCIELO. Resultados: foram revisados 18 artigos nos quais os métodos fisiológicos foram empregados para mensurar o esforço auditivo em indivíduos normo-ouvintes. Os principais achados dos artigos revisados se referem aos autore(s) e objetivo(s) da pesquisa, país onde a pesquisa foi conduzida, casuística, método fisiológico empregado e, resultados. Conclusão: não existe consenso entre os pesquisadores quanto ao melhor método fisiológico para mensurar este parâmetro, ou seja, este esforço nas tarefas de percepção de fala, embora o nível de condutância da pele tenha sido considerado a medida mais precisa até o momento.

Um Programa de Intervenção para Transtorno de Ansiedade Social com o Uso da Realidade Virtual / Un Programa de Intervención para la Trastorno de Ansiedad Social con el Uso de la Realidad Virtual / A Treatment Program for Social Anxiety Disorder by Using Virtual Reality

Resumo A Realidade Virtual (RV) foi utilizada nesse estudo como recurso terapêutico em uma intervenção analítico-comportamental para dois participantes com transtorno de ansiedade social. Os objetivos foram avaliar os efeitos terapêuticos do programa de intervenção e o simulador quanto à capacidade de gerar senso de presença e respostas de ansiedade. O programa consistiu em: (a) sessão inicial, (b) linha de base, (c) intervenção com exposição à RV, (d) encerramento e (e) follow up (1 e 3 meses após a intervenção). O senso de presença, ansiedade e respostas galvânicas da pele foram registrados em cada sessão com exposição e inventários de ansiedade, depressão e fobia social ao término de cada fase. Foram formuladas análises funcionais baseadas na ocorrência de comportamentos apresentados em contexto social no intervalo entre as sessões. O simulador produziu ansiedade e níveis elevados de presença ao longo das exposições; e ambos participantes apresentaram redução dos níveis de ansiedade ao fim do programa e generalização para o contexto natural. Conclui-se que a intervenção com exposição à RV apresentou efeito terapêutico e promoveu repertório de enfrentamento frente a situações de interação social.

Resumen La realidad virtual (RV) fue empleada en este estudio como herramienta terapéutica en un programa de intervención analítico-conductual para dos participantes con trastorno de ansiedad social. Los objetivos fueron evaluar los efectos terapéuticos del programa de intervención y el simulador en cuanto a la capacidad de generar presencia y respuestas de ansiedades. El programa consistió en: (a) sesión inicial, (b) línea base, (c) intervención con exposición a la RV, (d) finalización y (e) seguimiento (1 y 3 meses después de la intervención). La sensación de presencia, ansiedad y la respuesta galvánica de la pele fueron registrados en cada sesión con exposición y inventario de la ansiedad, depresión y fobia social al final de cada fase. Análisis funcionales fueron formulados en base a la ocurrencia de las conductas de interacción social en el intervalo entre las sesiones. El simulador produce ansiedad y niveles elevados de presencia a lo largo de las exposiciones y ambos participantes presentaron reducción de los niveles de ansiedad al final de lo programa, con generalización de los resultados para un contexto natural. Se concluye que la intervención analítico-conductual con la exposición a la RV tuvo efecto terapéutico y aprendieron un repertorio de afrontamiento de esas situaciones.

Abstract Virtual Reality (VR) was used in this study as a therapeutic tool in a behavior-analytic intervention with two subjects who had social anxiety disorder. The goals were to assess the therapeutic effects of the intervention program and the VR simulator with regard to the ability to generate sense of presence and anxiety responses. The program consisted of: (a) initial session, (b) baseline, (c) intervention sessions with exposure to VR, (d) closing session, (e) follow up (up to one and three months after treatment). Sense of presence, anxiety and galvanic skin response were reported in each exposure therapy session and anxiety, depression and social phobia inventories were reported at the end of each stage. Functional analyses were formulated based on behaviors occurring in social contexts between sessions. The simulator produced anxiety and high levels of presence during exposure; and both participants had reduced levels of anxiety at the end of intervention and generalization to the natural context. In conclusion, behavior-analytic intervention with exposure to VR was effective and fostered a repertoire for coping with situations of social interaction.

The Effect of Pain Relieving Intervention During Infiltration among Gamma Knife Surgery Patients for Stereotactic Frame Fixation

PURPOSE: This study aimed to compare the effects of three interventions on pain, blood pressure, and pulse rate during infiltration anesthesia in patients about to undergo gamma knife surgeries. METHODS: The three interventions employed in a university-affiliated Hospital in J City, South Korea were as follows: EMLA cream plus Vapocoolant spray (Vapocoolant, n=30), EMLA cream plus 10.0% Lidocaine spray (Lidocaine, n=30), and EMLA cream only (EMLA, n=30). The equivalent control-group pre test - post test study design was used. Pain was assessed subjectively using the numeric rating scale (NRS) and objectively using a Galvanic Skin Response (GSR) tester. NRS scores were assessed after infiltration anesthesia and the GSR was assessed during infiltration anesthesia. Blood pressure and pulse rate were assessed twice: before and after infiltration anesthesia. Data were collected between August 3, 2016 and March 24, 2017. RESULTS: NRS scores after infiltration anesthesia and the GSR during infiltration anesthesia were significantly lower in the Vapocoolant group than in the Lidocaine and EMLA groups (F=13.56, p < .001 and F=14.43, p < .001, respectively). The increase in systolic blood pressure (F=4.77, p=.011) and in pulse rates (F=4.78, p=.011) before and after infiltration anesthesia were significantly smaller in the Vapocoolant group than in the Lidocaine and EMLA groups; however, no significant differences were observed in diastolic blood pressures (F=1.51, p=.227). CONCLUSION: EMLA cream plus Vapocoolant spray was the most effective intervention to relieve pain and to lower increase in systolic blood pressure and pulse rate caused by infiltration anesthesia for stereotactic frame fixation. Thus, application of Vapocoolant spray in addition to EMLA cream is highly recommended as a nursing intervention for patients undergoing gamma knife surgeries.

Rapid, Objective and Non-invasive Diagnosis of Sudomotor Dysfunction in Patients With Lower Extremity Dysesthesia: A Cross-Sectional Study

OBJECTIVE: To determine whether patients with lumbosacral (LS) radiculopathy and peripheral polyneuropathy (PPNP) exhibit sudomotor abnormalities and whether SUDOSCAN (Impeto Medical, Paris, France) can complement nerve conduction study (NCS) and electromyography (EMG). METHODS: Outpatients with lower extremity dysesthesia underwent electrophysiologic studies and SUDOSCAN. They were classified as normal (group A), LS radiculopathy (group B), or PPNP (group C). Pain severity was measured by the Michigan Neuropathy Screening Instrument (MNSI) and visual analogue scale (VAS). Demographic features, electrochemical skin conductance (ESC) values on hands and feet, and SUDOSCAN-risk scores were analyzed. RESULTS: There were no statistical differences in MNSI and VAS among the three groups. Feet-ESC and hands-ESC values in group C were lower than group A and B. SUDOSCAN-risk score in group B and C was higher than group A. With a cut-off at 48 microSiemens of feet-ESC, PPNP was detected with 57.1% sensitivity and 94.2% specificity (area under the curve [AUC]=0.780; 95% confidence interval [CI], 0646–0.915). With a SUDOSCAN-risk score cut-off at 29%, NCS and EMG abnormalities related to LS radiculopathy and PPNP were detected with 64.1% sensitivity and 84.2% specificity (AUC=0.750; 95% CI, 0.674–0.886). CONCLUSION: SUDOSCAN can discriminate outpatients with abnormal electrophysiological findings and sudomotor dysfunction. This technology may be a complementary tool to NCS and EMG in outpatients with lower extremity dysesthesia.

Predictive Value of Sympathetic Skin Response in Diagnosing Complex Regional Pain Syndrome: A Case-Control Study

OBJECTIVE: To investigate the predictive value of the sympathetic skin response (SSR) in diagnosing complex regional pain syndrome (CRPS) by comparing three diagnostic modalities-SSR, three-phasic bone scans (TPBS), and thermography. METHODS: Thirteen patients with severe limb pain were recruited. Among them, 6 were diagnosed with CRPS according to the proposed revised CRPS clinical diagnostic criteria described by the International Association for the Study of Pain. SSR was measured in either the hands or feet bilaterally and was considered abnormal when the latency was prolonged. A positive TPBS finding was defined as diffuse increased tracer uptake on the delayed image. Thermographic findings were considered positive if a temperature asymmetry greater than 1.00degrees C was detected between the extremities. RESULTS: Five of 6 CRPS patients showed prolonged latency on SSR (83% sensitivity). TPBS was positive in the 5 CRPS patients who underwent TPBS (100% sensitivity). Thermography was positive in 4 of 5 CRPS patients who underwent the procedure (80% sensitivity). The remaining 7 non-CRPS patients differed on examination. SSR latencies within normal limit were noted in 4 of 7 non-CRPS patients (57% specificity). Results were negative in 4 of 5 non-CRPS patients who underwent TPBS (80% specificity), and negative in 3 of 5 non-CRPS patients who underwent thermography (60% specificity). CONCLUSION: SSR may be helpful in detecting CRPS.

Effects of Topical Anesthetic Cream on Pain at Venipuncture in Children

PURPOSE: This study was done to evaluate the effectiveness of EMLA cream on pain related to venipuncture among children. METHODS: In this study, 48 children were evaluated using a sequential measurement for level of pain by Skin Conductance Level (SCL) based on Galvanic Skin Response (GSR), heart rate, and the Visual Analogue Scale (VAS) at four times. RESULTS: The maximum and mean of the SCL were each significantly different between the experimental and control groups and furthermore, the two were also significantly different among observed times. In addition there was a significant interaction between group and time. The children's perceived pain using VAS was not significantly different between the experimental and control groups. There was no significant difference in the heart rate between the experimental and control groups; however, the interaction between group and time was significant. CONCLUSION: In conclusion, applying topical anesthetic cream to the venipuncture site to reduce pain was effective among the children and therefore it is highly recommended that topical anesthetic cream be applied at the venipuncture site as a nursing intervention to reduce pain when a child has to undergo a venipuncture.

BIS versus skin conductance for assessment of depth of sedation induced by propofol target-controlled infusion / 中华麻醉学杂志

Objective To compare the accuracy of BIS and skin conductance (SC) for assessment of the depth of sedation induced by target-controlled infusion (TCI) of propofol. Methods Thirty ASA Ⅰ orⅡpatients aged 21-56 yr weighing 52-85 kg undergoing orthopedic operation on the lower limb under epidural anesthesia were enrolled in this study.After the onset of epidural anesthesia, TCI of propofol was started at an initial target plasma concentration (Cp) of 0.8 μg/ml. Th Cp was increased by 0.5-0.8 μg/ml every 3 min until OAA/S score=1. OAA/S score, BIS and SC values were recorded, SC change value (△SC) was calculated. Spearman rank-order correlation, receiver operating characteristic curve (area under curve AUC was calculated) and logistic regression were used to analyze the relationship of OAA/S score to BIS and △SC.Results BIS and △SC were significantly correlated with OAA/S scores (r were 0.920 and-0.859 respectively). The AUC of △SC (0.919, 0.946) was significantly better correlated with OAA/S score (5→4, 4→3) than that of BIS (0.761, 0.507), while BIS was better correlated (0.781, 0.959) with OAA/S score (3→2, 2→1) than ASC (0.577, 0.630). Logistic regression correctly predicted loss of consciousness. The accuracy of prediction was 93% for BIS and 82% for △SC. Conclusion The accuracy of SC for assessment of the depth of sedation induced by propofol TCI ishigher than that of BIS before loss of consciousness,while lower than that of BIS after loss of consciousness. BIS is more accurate in monitoring the loss of consciousness.

Changes of Autonomic Nervous Function after Foot Bathing in Normal Adults

OBJECTIVE: To monitor the changes of autonomic nervous function before and after foot bathing through autonomic function tests using electrophysiological instrument. METHOD: Twenty five healthy adults took a foot bathing through popular 'foot bath' for 30 minutes at 43degrees C. Autonomic tests were performed three times before foot bathing, immediately and 15 minutes after foot bathing. Sympathetic skin response (SSR) and blood pressure after sustained grip for sympathetic tone, heart rate variation during deep breathing and Valsalva maneuver for parasympathetic tone (Expiratory/Inspiratory (E/I) ratio, Valsalva ratio) were measured. RESULTS: SSR amplitudes in one hand decreased significantly during foot bathing (p0.05). CONCLUSION: Heat therapy through foot bathing in normal adults reduced sudomotor response to electrical stimuli, which can be considered as reduction of specific sympathetic nervous function. We propose that foot bathing could be promising one of partial heat therapies for pain without cardiovascular complications unlike conventional whole body bathing.

Biofeedback e resistência galvânica da pele: medidas em pacientes com síndrome do intestino irritável e em indivíduos saudáveis / Biofeedback and galvanic resistance of the skin: measures in patientswith irritable bowel syndrome and in healthy individuals

OBJETIVO:Avaliar e comparar a intensidade da resistência galvânica da pele (resposta autonômica) entre pacientes portadores da síndrome do intestino irritável e indivíduos saudáveis. MÉTODOS: Os participantes deste estudo formaram dois grupos distintos, um experimentale outro controle, compostos de 16 pessoas cada um. A coleta de dados foi feitaindividualmente em dez medidas distintas, realizadas semanalmente com autilização do medidor galvânico de resistência da pele (aparelho de biofeedback). A duração das medidas foi de três minutos, tendo sido registradas em forma de gráficos específicos. RESULTADOS: Os resultados foram analisados comparando-se todas as medidas intra eintergrupos nos diversos momentos. Os dados deste estudo demonstraram que um dos componentes regulados pelo sistema nervoso autônomo - a resistência galvânica da pele - não está prejudicado nos pacientes com síndrome do intestino irritável em comparação aos pacientes saudáveis. CONCLUSÃO: Sugere-se que novas pesquisas sejam realizadas com maior número de pacientes e com uma avaliação mais abrangente das respostas autonômicas somatoformes, auxiliando a compreensão da etiologia dessa enfermidade.

OBJECTIVE: This study evaluates and compares the intensity of the galvanic resistance of theskin (autonomic reply) of patients with Irritable Bowel Syndrome and healthyindividuals. METHODS: The participants of this study were divided into two distinct groups, oneexperimental and another control, with 16 people in each. Data collection occurredindividually in 10 distinct measures, performed weekly with the use of the galvanicmeasurer of resistance of the skin (Device of Biofeedback). Measurements took 3minutes and were recorded in the form of graphs. RESULTS: The results were analyzed by comparing all the intra and intergroup measurements in the different moments. Data of this study show that one of the components regulated by the autonomous nervous system - galvanic resistance of the skin - isnot compromised in patients with irritable bowel syndrome when compared withhealthy individuals. CONCLUSION: We suggest that more research is done with a higher number of patients and a broader evaluation of the somatoform autonomic responses, in order to improvethe understanding of the etiology of this disease.

Condicionamiento clásico y cognición implícita / Classical conditioning and implicit cognition

En su conjunto, las evidencias experimentales conductuales y psicobiológicas revisadas en este artículo muestran que el condicionamiento clásico humano tiene una justificación evolutiva, se desarrolla mediante un procesamiento cognitivo diferente del procesamiento consciente y se sustenta en estructuras cerebrales diferentes. Dichas estructuras no suelen funcionar desligadas y por ello la combinación de ambas formas de procesamiento, explícito e implícito, es el patrón general en condiciones naturales. De hecho, debido a la organización jerárquica del sistema nervioso, suele existir un proceso de control de arriba hacia abajo (cortical-subcortical) pero, bajo condiciones especiales de laboratorio, puede hacerse evidente en la conducta, por ejemplo mediante los paradigmas de miedo condicionado, la estrecha relación entre procesamiento implícito y el condicionamiento clásico en nuestra especie.

Experimental data, behavioral and psychobiological, reviewed in this paper show that human classical conditioning has an evolutionary purpose, it is developed by means of a cognitive processing different from the conscious processing, and sustained by different cerebral structures. These structures usually do not work isolated. For that reason, combination of both forms of processing, explicit/implicit, is the general pattern in natural conditions. In fact, due to the hierarchical organization of the nervous system, usually it exists a top-down control process (cortical-subcortical) but, under special conditions of laboratory, can be behaviorally evident, for example by means of the fear conditioning, close relationship between implicit processing and Pavlovian conditioning in humans.