Individual Differences in Indirect Speech Act Processing Found Outside the Language Network.

Face-to-face communication requires skills that go beyond core language abilities. In dialogue, we routinely make inferences beyond the literal meaning of utterances and distinguish between different speech acts based on, e.g., contextual cues. It is, however, not known whether such communicative skills potentially overlap with core language skills or other capacities, such as theory of mind (ToM). In this functional magnetic resonance imaging (fMRI) study we investigate these questions by capitalizing on individual variation in pragmatic skills in the general population. Based on behavioral data from 199 participants, we selected participants with higher vs. lower pragmatic skills for the fMRI study (N = 57). In the scanner, participants listened to dialogues including a direct or an indirect target utterance. The paradigm allowed participants at the whole group level to (passively) distinguish indirect from direct speech acts, as evidenced by a robust activity difference between these speech acts in an extended language network including ToM areas. Individual differences in pragmatic skills modulated activation in two additional regions outside the core language regions (one cluster in the left lateral parietal cortex and intraparietal sulcus and one in the precuneus). The behavioral results indicate segregation of pragmatic skill from core language and ToM. In conclusion, contextualized and multimodal communication requires a set of interrelated pragmatic processes that are neurocognitively segregated: (1) from core language and (2) partly from ToM.

Oxytocin prolongs the gastric emptying time in patients with diabetes mellitus and gastroparesis, but does not affect satiety or volume intake in patients with functional dyspepsia.

BACKGROUND: Oxytocin is released in response to a fatty meal. Blockage of the oxytocin receptor led to slower gastric emptying whereas stimulation resulted in less satiety in healthy volunteers. Patients with diabetes mellitus and gastroparesis lack oxytocin elevation, and dyspepsia is partly caused by reduced fundus accommodation causing early satiety and related symptoms. The aim of this study was thus to examine the effect of oxytocin on gastric emptying, satiety and volume intake in patients with gastrointestinal pathology. RESULTS: Gastric emptying scintigraphy was performed twice in 12 patients with diabetic gastroparesis, once with oxytocin and once with saline as intravenous infusions. The patients scored their sensation of satiety using a visual analogue scale (VAS). The gastric emptying in patients with gastroparesis was prolonged during oxytocin infusion (p = 0.034) without affecting satiety. A slow satiety drinking test was performed in 14 patients with functional dyspepsia. The patients scored their satiety every five minutes until maximal satiety was reached, and the total volume was determined. The VAS was also completed 30 minutes afterwards. The test was performed twice, once with oxytocin and once with saline as intravenous infusions. There was no difference in satiety scores or volume of nutrient intake between saline and oxytocin infusions, either before, during or after the meal. CONCLUSIONS: Oxytocin prolongs gastric emptying in patients with diabetes mellitus and gastroparesis, but has no effect on volume of nutrient intake or satiety and other related symptoms in patients with functional dyspepsia.

Gastroparesis is associated with oxytocin deficiency, oesophageal dysmotility with hyperCCKemia, and autonomic neuropathy with hypergastrinemia.

BACKGROUND: Gastrointestinal (GI) dysmotility and autonomic neuropathy are common problems among diabetics with largely unknown aetiology. Many peptides are involved in the autonomic nervous system regulating the GI tract. The aim of this study was to examine if concentrations of oxytocin, cholecystokinin (CCK), gastrin and vasopressin in plasma differ between diabetics with normal function and dysfunction in GI motility. METHODS: Nineteen patients with symptoms from the GI tract who had been examined with gastric emptying scintigraphy, oesophageal manometry, and deep-breathing test were included. They further received a fat-rich meal, after which blood samples were collected and plasma frozen until analysed for hormonal concentrations. RESULTS: There was an increase in postprandial oxytocin plasma concentration in the group with normal gastric emptying (p = 0.015) whereas subjects with delayed gastric emptying had no increased oxytocin secretion (p = 0.114). Both CCK and gastrin levels increased after the meal, with no differences between subjects with normal respective delayed gastric emptying. The concentration of vasopressin did not increase after the meal. In patients with oesophageal dysmotility the basal level of CCK tended to be higher (p = 0.051) and those with autonomic neuropathy had a higher area under the curve (AUC) of gastrin compared to normal subjects (p = 0.007). CONCLUSION: Reduced postprandial secretion of oxytocin was found in patients with delayed gastric emptying, CCK secretion was increased in patients with oesophageal dysmotility, and gastrin secretion was increased in patients with autonomic neuropathy. The findings suggest that disturbed peptide secretion may be part of the pathophysiology of digestive complications in diabetics.