The effectiveness of nurses' psychosocial interventions for sensory deprivation in intensive care patients: a systematic review and meta-analysis.

OBJECTIVE: This systematic review and meta-analysis aimed to assess the effectiveness of nurses' psychosocial interventions for addressing sensory deprivation in intensive care units (ICUs). MATERIALS AND METHODS: A comprehensive search of PubMed, Web of Science, EBSCOhost, Google Scholar, CINAHL, Embase, Cochrane Library, and YÖK Thesis Center databases was conducted from August 2023 to May 2024, without any temporal restrictions. In addition, a physical search was made in the university library for grey literature. RESULTS: The study revealed that nurses' psychosocial interventions significantly improved patients' level of consciousness (SMD = 1.042, %95 CI = 0.716 to 1.369; Z = 6.25; p < .05) and sleep quality in ICUs (SMD=1.21, 95% CI= 0.232 to 1.810; Z = 2.49; p < .05). The effectiveness of psychosocial interventions varied based on the type of intervention, patient age, ICU type, patient group, and intervention duration. Notably, auditory stimuli and aromatherapy demonstrated particularly high effect sizes, significantly enhancing patients' levels of consciousness and sleep quality. CONCLUSION: In conclusion, psychosocial interventions aimed at reducing sensory deprivation in intensive care units exert beneficial effects on individuals, notably enhancing their level of consciousness and improving sleep quality.

Sensorineural hearing loss and cognitive impairment: three hypotheses.

Sensorineural hearing loss (SNHL) is a category of hearing loss that often leads to difficulty in understanding speech and other sounds. Auditory system dysfunction, including deafness and auditory trauma, results in cognitive deficits via neuroplasticity. Cognitive impairment (CI) refers to an abnormality in the brain's higher intellectual processes related to learning, memory, thinking and judgment that can lead to severe learning and memory deficits. Studies have established a strong correlation between SNHL and CI, but it remains unclear how SNHL contributes to CI. The purpose of this article is to describe three hypotheses regarding this relationship, the mainstream cognitive load hypothesis, the co-morbidity hypothesis, and the sensory deprivation hypothesis, as well as the latest research progress related to each hypothesis.

Ambient sound stimulation tunes axonal conduction velocity by regulating radial growth of myelin on an individual, axon-by-axon basis.

Adaptive myelination is the emerging concept of tuning axonal conduction velocity to the activity within specific neural circuits over time. Sound processing circuits exhibit structural and functional specifications to process signals with microsecond precision: a time scale that is amenable to adjustment in length and thickness of myelin. Increasing activity of auditory axons by introducing sound-evoked responses during postnatal development enhances myelin thickness, while sensory deprivation prevents such radial growth during development. When deprivation occurs during adulthood, myelin thickness was reduced. However, it is unclear whether sensory stimulation adjusts myelination in a global fashion (whole fiber bundles) or whether such adaptation occurs at the level of individual fibers. Using temporary monaural deprivation in mice provided an internal control for a) differentially tracing structural changes in active and deprived fibers and b) for monitoring neural activity in response to acoustic stimulation of the control and the deprived ear within the same animal. The data show that sound-evoked activity increased the number of myelin layers around individual active axons, even when located in mixed bundles of active and deprived fibers. Thicker myelination correlated with faster axonal conduction velocity and caused shorter auditory brainstem response wave VI-I delays, providing a physiologically relevant readout. The lack of global compensation emphasizes the importance of balanced sensory experience in both ears throughout the lifespan of an individual.

Direct reciprocity and reputation shape trust decisions similarly in blind and sighted individuals.

This study addresses the effects of blindness on trust. Using an auditory version of the multi-round Trust Game, we investigated the effect of reputation and reciprocity on trust decisions in early blind and sighted participants. During each round of the game, participants were endowed with a sum of money and had to decide how much they wanted to invest in their partners, who were manipulated as a function of their good or bad reputation and individualistic or cooperative behavior. The data showed that negative first impression about the partner (bad reputation and/or selfish behavior) impacted more blind participants than sighted ones. However, following repeated interactions with the partners, the overall mean investment aligned between the blind and sighted groups. We interpret these findings as suggesting that blindness may guide participants to a more cautionary behavior when dealing with partners with negative initial characteristics.

Deprivation-Induced Plasticity in the Early Central Circuits of the Rodent Visual, Auditory, and Olfactory Systems.

Activity-dependent neuronal plasticity is crucial for animals to adapt to dynamic sensory environments. Traditionally, it has been investigated using deprivation approaches in animal models primarily in sensory cortices. Nevertheless, emerging evidence emphasizes its significance in sensory organs and in subcortical regions where cranial nerves relay information to the brain. Additionally, critical questions started to arise. Do different sensory modalities share common cellular mechanisms for deprivation-induced plasticity at these central entry points? Does the deprivation duration correlate with specific plasticity mechanisms? This study systematically reviews and meta-analyzes research papers that investigated visual, auditory, or olfactory deprivation in rodents of both sexes. It examines the consequences of sensory deprivation in homologous regions at the first central synapse following cranial nerve transmission (vision - lateral geniculate nucleus and superior colliculus; audition - ventral and dorsal cochlear nucleus; olfaction - olfactory bulb). The systematic search yielded 91 papers (39 vision, 22 audition, 30 olfaction), revealing substantial heterogeneity in publication trends, experimental methods, measures of plasticity, and reporting across the sensory modalities. Despite these differences, commonalities emerged when correlating plasticity mechanisms with the duration of sensory deprivation. Short-term deprivation (up to 1 d) reduced activity and increased disinhibition, medium-term deprivation (1 d to a week) involved glial changes and synaptic remodeling, and long-term deprivation (over a week) primarily led to structural alterations. These findings underscore the importance of standardizing methodologies and reporting practices. Additionally, they highlight the value of cross-modal synthesis for understanding how the nervous system, including peripheral, precortical, and cortical areas, respond to and compensate for sensory inputs loss.

Cortical surface plasticity promotes map remodeling and alleviates tinnitus in adult mice.

Tinnitus induced by hearing loss is caused primarily by irreversible damage to the peripheral auditory system, which results in abnormal neural responses and frequency map disruption in the central auditory system. It remains unclear whether and how electrical rehabilitation of the auditory cortex can alleviate tinnitus. We hypothesize that stimulation of the cortical surface can alleviate tinnitus by enhancing neural responses and promoting frequency map reorganization. To test this hypothesis, we assessed and activated cortical maps using our newly designed graphene-based electrode array with a noise-induced tinnitus animal model. We found that cortical surface stimulation increased cortical activity, reshaped sensory maps, and alleviated hearing loss-induced tinnitus behavior in adult mice. These effects were likely due to retained long-term synaptic potentiation capabilities, as shown in cortical slices from the mice model. These findings suggest that cortical surface activation can be used to facilitate practical functional recovery from phantom percepts induced by sensory deprivation. They also provide a working principle for various treatment methods that involve electrical rehabilitation of the cortex.

Musical hallucinations, secondary delusions, and lack of insight: results from a cohort study.

Introduction: Although musical hallucinations do not tend to be accompanied by delusions, occasionally patients persistently accuse others of being responsible for causing the music they perceive, sometimes with severe social consequences such as frequently calling the police or moving house. In this study we seek to broaden our understanding of this rare type of musical hallucination that comes with secondary delusions and lack of insight, and to explore associations, underlying mechanisms, and treatment possibilities. Methods: The present study is part of a cohort study on musical hallucinations carried out in the Netherlands from 2010 through 2023. Participants underwent testing with the aid of the MuHa Questionnaire, Launay-Slade Hallucinations Scale (LSHS), Schizotypal Personality Questionnaire (SPQ), Hamilton Depression Rating Scale (HDRS), and Mini Mental State Examination (MMSE). Additionally, they underwent a brain MRI, electroencephalogram, and audiological testing. Results: Five patients out of a group of N = 81 (6%) lacked insight and presented with secondary delusions regarding the perceived music. They were all female, of advanced age, and hearing-impaired, and were diagnosed with cognitive impairment. In three patients (60%), risperidone was started. This had a positive effect on the hallucinations and secondary delusions. Conclusion: The pathophysiological process underlying musical hallucinations is multifactorial in nature. We consider cognitive impairment the most likely contributing factor of the secondary delusions and lack of insight encountered in our patients, and antipsychotics the most beneficial treatment. On the basis of these small numbers, no definite conclusions can be drawn, so further research is needed to elucidate the underlying mechanisms and to develop evidence-based treatment methods for people experiencing this rare and debilitating combination of symptoms. Since the black box warning of risperidone cautions against the use of this drug in elderly persons with dementia, a proper comparison with the efficacy and safety of other antipsychotics for this group is paramount.

Effects of social and sensory deprivation in newborns: A lesson from the Covid-19 experience.

BACKGROUND: Infancy is a complex period of human life, in which environmental experiences have a fundamental role for neurodevelopment. Although conditions of social and sensory deprivation are uncommon in high income countries, the Covid-19 pandemic abruptly modified this condition, by depriving people of their social stimuli of daily life. AIM: To understand the impact of this deprivation on infants' behaviour, we investigated the short-term effects of isolation and use of individual protective systems by mothers during the first two weeks of life. METHODS: The study included 11 mother-infant dyads with mothers tested positive to SARS-CoV-2 at the time of delivery (Covid group) and 11 dyads with a SARS-CoV-2 negative mother as controls. Neurobehavioral, visual, and sensory processing assessments were performed from birth to 3 months of age. RESULTS: Findings showed the effect of deprivation on some neurobehavioral abilities of infants in the Covid group; in addition, differences in sensory maturation trends were observed, although they tended to gradually decrease until disappearance at 3 months of age. CONCLUSION: These findings suggest the significant effects of early sensory and social deprivation during the first two weeks of life, but also provide several insights on the ability of the brain to restore its aptitudes by deleting or reducing the effects of early deprivation before the critical periods' closure.

Sensory deprivation arrests cellular and synaptic development of the night-vision circuitry in the retina.

Experience regulates synapse formation and function across sensory circuits. How inhibitory synapses in the mammalian retina are sculpted by visual cues remains unclear. By use of a sensory deprivation paradigm, we find that visual cues regulate maturation of two GABA synapse types (GABAA and GABAC receptor synapses), localized across the axon terminals of rod bipolar cells (RBCs)-second-order retinal neurons integral to the night-vision circuit. Lack of visual cues causes GABAA synapses at RBC terminals to retain an immature receptor configuration with slower response profiles and prevents receptor recruitment at GABAC synapses. Additionally, the organizing protein for both these GABA synapses, LRRTM4, is not clustered at dark-reared RBC synapses. Ultrastructurally, the total number of ribbon-output/inhibitory-input synapses across RBC terminals remains unaltered by sensory deprivation, although ribbon synapse output sites are misarranged when the circuit develops without visual cues. Intrinsic electrophysiological properties of RBCs and expression of chloride transporters across RBC terminals are additionally altered by sensory deprivation. Introduction to normal 12-h light-dark housing conditions facilitates maturation of dark-reared RBC GABA synapses and restoration of intrinsic RBC properties, unveiling a new element of light-dependent retinal cellular and synaptic plasticity.

Effects of sensory deprivation on glomerular interneurons in the mouse olfactory bulb: differences in mortality and phenotypic adjustment of dopaminergic neurons.

Neurogenesis persists in the mammalian subventricular zone after birth, producing various populations of olfactory bulb (OB) interneurons, including GABAergic and mixed dopaminergic/GABAergic (DA) neurons for the glomerular layer. While olfactory sensory activity is a major factor controlling the integration of new neurons, its impact on specific subtypes is not well understood. In this study we used genetic labeling of defined neuron subsets, in combination with reversible unilateral sensory deprivation and longitudinal in vivo imaging, to examine the behavior of postnatally born glomerular neurons. We find that a small fraction of GABAergic and of DA neurons die after 4 weeks of sensory deprivation while surviving DA-neurons exhibit a substantial decrease in tyrosine hydroxylase (TH) expression levels. Importantly, after reopening of the naris, cell death is arrested and TH levels go back to normal levels, indicating a specific adaptation to the level of sensory activity. We conclude that sensory deprivation induces adjustments in the population of glomerular neurons, involving both, cell death and adaptation of neurotransmitter use in specific neuron types. Our study highlights the dynamic nature of glomerular neurons in response to sensory deprivation and provide valuable insights into the plasticity and adaptability of the olfactory system.

Microglia enable cross-modal plasticity by removing inhibitory synapses.

Cross-modal plasticity is the repurposing of brain regions associated with deprived sensory inputs to improve the capacity of other sensory modalities. The functional mechanisms of cross-modal plasticity can indicate how the brain recovers from various forms of injury and how different sensory modalities are integrated. Here, we demonstrate that rewiring of the microglia-mediated local circuit synapse is crucial for cross-modal plasticity induced by visual deprivation (monocular deprivation [MD]). MD relieves the usual inhibition of functional connectivity between the somatosensory cortex and secondary lateral visual cortex (V2L). This results in enhanced excitatory responses in V2L neurons during whisker stimulation and a greater capacity for vibrissae sensory discrimination. The enhanced cross-modal response is mediated by selective removal of inhibitory synapse terminals on pyramidal neurons by the microglia in the V2L via matrix metalloproteinase 9 signaling. Our results provide insights into how cortical circuits integrate different inputs to functionally compensate for neuronal damage.

Long-term cortical plasticity following sensory deprivation is reduced in male Rett model mice.

PURPOSE/AIM: Rett (RTT) syndrome, a neurodevelopmental disorder, results from loss-of-function mutations in methyl-CpG-binding protein 2. We studied activity-dependent plasticity induced by sensory deprivation via whisker trimming in early symptomatic male mutant mice to assess neural rewiring capability. METHODS: One whisker was trimmed for 0-14 days and intrinsic optical imaging of the transient reduction of brain blood oxygenation resulting from neural activation by 1 second of wiggling of the whisker stump was compared to that of an untrimmed control whisker. RESULTS: Cortical evoked responses to wiggling a non-trimmed whisker were constant for 14 days, reduced for a trimmed whisker by 49.0 ± 4.3% in wild type (n = 14) but by only 22.7 ± 4.6% in mutant (n = 18, p = 0.001). CONCLUSION: As the reduction in neural activation following sensory deprivation in whisker barrel cortex is known to be dependent upon evoked and basal neural activity, impairment of cortical re-wiring following whisker trimming provides a paradigm suitable to explore mechanisms underlying deficiencies in the establishment and maintenance of synapses in RTT, which can be potentially targeted by therapeutics.

Adding Sound Transparency to a Spacesuit: Effect on Cognitive Performance in Females.

Spacesuits may block external sound. This induces sensory deprivation; a side effect is lower cognitive performance. This can increase the risk of an accident. This undesirable effect can be mitigated by designing suits with sound transparency. If the atmosphere is available, as on Mars, sound transparency can be realized by augmenting and processing external sounds. If no atmosphere is available, such as on the Moon, then an Earth-like sound can be re-created via generative AR techniques. We measure the effect of adding sound transparency in an Intra-Vehicular Activity suit by means of the Koh Block test. The results indicate that participants complete the test more quickly when wearing a suit with sound transparency.

Synaptic Remodeling of the Auditory Cortex Following Bilateral Blindness: Evidence of Cross-modal Plasticity.

We aimed to evaluate structural dynamic changes of neurons in the auditory cortex after visual deprivation. We longitudinally tracked dendritic spines for 3 weeks after visual deprivation in vivo using a two-photon microscope. GFP-labeled dendritic spines in the auditory cortex were serially followed after bilateral enucleation. The turnover rate, density, and size of the spines in the dendrites were evaluated 1, 2, and 3 weeks after visual deprivation. The turnover rate of the dendritic spines in the auditory cortex increased at 1 week (20.1±7.3%) after bilateral enucleation compared to baseline (12.5±7.9%); the increase persisted for up to 3 weeks (20.9±11.0%). The spine loss rate was slightly higher than the spine gain rate. The average spine density (number of spines per 1 µm of dendrite) was significantly lower at 2 weeks (2W; 0.22±0.06 1/µm) and 3 W (0.22±0.08 1/µm) post-nucleation compared to baseline (0.026±0.09 1/µm). We evaluated the change of synaptic strength in the stable spines at each time point. The normalized spine size in the auditory cortex was significantly increased after bilateral blindness at 1 W postoperatively (1.36±0.92), 2 W postoperatively (1.40±1.18), and 3 W postoperatively (1.36±0.88) compared to baseline. Sensory deprivation resulted in remodeling of the neural circuitry in the spared cortex, via cross-modal plasticity in the direction of partial breakdown of synapses, and enhanced strength of the remaining synapses.

Applications of methods of psychological support developed for astronauts for use in medical settings.

Over the past 40 years, psychological support (PS) for cosmonauts and astronauts has remained an important part of the regular biomedical provision of space crews during extended orbital flights. It includes well-developed principles and a set of methods that have proven its effectiveness for the maintenance of behavioral health under extreme conditions of space flight. The main principle of PS in flight is to restore the usual sensory input to compensate for the monotony and lack of external stimuli as a result of a long stay under isolation and confinement. Risk factors for the psychological health and well-being defined for the astronauts, such as sensory and social deprivation, monotony, confinement, and lack of privacy, also remain part and parcel of several civil professions. These include polar wintering, submarines, working on oil platforms, and ocean fishing. Most of these factors also adversely affect the recovery rate of a large contingent of medical institutions, especially bedridden patients with chronic diseases. Finally, due to the negative epidemiological situation associated with the spread of COVID-19, an increasingly wide range of citizens forced to be in self-isolation faces negative manifestations of the deprivation phenomena described previously. Several cases of successful use of PS under isolation, monotony, crowding, and confinement are presented. Thus, we assume that the use of psychological support methods developed for space flights could be extremely relevant in civil medicine and everyday life.

Effects of Visual Deprivation on Remodeling of Nodes of Ranvier in Optic Nerve.

Oligodendrocytes, the myelinating cells of the CNS, promote rapid action potential conduction along axons. Changes in the geometry of gaps between myelin segments, known as nodes of Ranvier, affect the conduction speed of neuronal impulses and can ultimately alter neural synchronization and circuit function. In contrast to synaptic plasticity, much less is known about how neural activity may affect node of Ranvier structure. Recently, perinodal astrocytes have been shown to remodel nodes of Ranvier by regulating thrombin proteolysis, but it is not known whether neural activity influences this process. To test this hypothesis, we used transgenic mice with astrocytic expression of a dominant-negative vesicle-associated membrane protein 2 ([gfap]dnVAMP2) to reduce exocytosis of thrombin inhibitors, modulating astrocytic regulation of paranodal loop attachment to induce nodal remodeling, under normal conditions and in adult mice maintained in darkness from postnatal day 40 (P40) to P70. This mechanism of nodal lengthening proceeded normally following binocular visual deprivation (BVD). The effect of BVD on nodal plasticity in animals with unimpaired astrocyte function has not been previously investigated. We find that when exocytosis from astrocytes was unimpaired, nodal gap length was not altered by BVD in adult mice. We conclude that if perinodal astrocytes participate in activity-dependent myelin remodeling through exocytosis, then, as with synaptic plasticity in the visual system, the process must be driven by alterations in neuronal firing other than those produced by BVD.

Sensory Deprivation and Psychiatric Disorders: Association, Assessment and Management Strategies.

Background: Sensory deprivation (SD) is a widely prevalent condition that leads to various health-related consequences and is also an important cause of disability worldwide. Earlier, SD experiments were used as research modalities to alter human behavior. In recent years, the focus has shifted to understand how SD can affect the mental health of individuals (with congenital or acquired sensory impairments). This narrative review focuses on the current understanding about the association of SD and psychiatric disorders. Methods: A comprehensive literature search was done PubMed, Scopus, PsycINFO, and Google Scholar and in the cross-references of relevant articles. Keywords included "sensory deprivation," "blindness," "deafness," "mental illness," "psychiatric disorders," "prevalence," "assessment," and "management" in various combinations. Only original articles (abstract and full text) published in English till October 2020 were included. Results: The prevalence of anxiety, depression, dementia, suicidality, and psychosis in persons with SD is higher than the general population (highest being in persons with dementia with comorbid SD). Several mechanisms/hypotheses have been proposed to explain these associations. Assessment of SD includes a thorough history taking, with adequate awareness about the difficulties faced during a psychiatric interview in this population. Modifications in the psychometric assessment procedures are warranted. Management depends on a multi-disciplinary approach that includes proper referral to specialties, pharmacological management (depending on diagnosis as well as taking care of ototoxic/ocular side-effect profile of the drugs), and nonpharmacological supportive measures. Conclusions: SD is a complex condition, and evidence suggests that persons with SD have higher psychiatric morbidity. A comprehensive assessment, along with holistic management approach is warranted.

Proprioceptive art: How should it be defined, and why has it become so popular?

In recent years, there has been something of an explosion of interest in those artworks and installations that directly foreground the bodily senses. Often referred to as proprioceptive (or prop.) art, the question to be addressed in this narrative historical review is how it should be defined, and why has it become so popular? A contrast is drawn with examples of sculpture and/or tactile art. The entertainment/experiential element of such works cannot be denied, especially in an era where funding in the arts sector is so often linked to footfall. At the same time, however, a number of the works appear to be about little more than entertainment/amusement. One might wonder why such "edutainment" should be placed in the art gallery rather than, say, in a museum of science or illusion. Nevertheless, in the best cases, the foregrounding, or removal, of bodily sensations that proprioceptive artworks deliver can potentially help to connect people in an increasingly digital, online, mostly audiovisual, and hence in some sense disembodied contemporary existence. These issues are discussed in the context of the works of Carsten Höller, a prolific German installation and object artist.

A circuit mechanism for independent modulation of excitatory and inhibitory firing rates after sensory deprivation.

Diverse interneuron subtypes shape sensory processing in mature cortical circuits. During development, sensory deprivation evokes powerful synaptic plasticity that alters circuitry, but how different inhibitory subtypes modulate circuit dynamics in response to this plasticity remains unclear. We investigate how deprivation-induced synaptic changes affect excitatory and inhibitory firing rates in a microcircuit model of the sensory cortex with multiple interneuron subtypes. We find that with a single interneuron subtype (parvalbumin-expressing [PV]), excitatory and inhibitory firing rates can only be comodulated-increased or decreased together. To explain the experimentally observed independent modulation, whereby one firing rate increases and the other decreases, requires strong feedback from a second interneuron subtype (somatostatin-expressing [SST]). Our model applies to the visual and somatosensory cortex, suggesting a general mechanism across sensory cortices. Therefore, we provide a mechanistic explanation for the differential role of interneuron subtypes in regulating firing rates, contributing to the already diverse roles they serve in the cortex.