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Mild problem-solving task improves brain function after a concussion, new study suggests

A simple cognitive task as early as four days after a brain injury activates the region that improves memory function, and may guard against developing depression or anxiety

Concern is growing about the danger of sports-related concussions and their long-term impact on athletes. But physicians and healthcare providers acknowledge that the science is evolving, leaving questions about rehabilitation and treatment options.

Currently, guidelines recommend that traumatic brain injury patients get plenty of rest and avoid physical and cognitive activity until symptoms subside.

But a new pilot study looking at athletes with concussions suggests total inactivity may not be the best way to recover after all, say scientists at Southern Methodist University, Dallas, where the research was conducted.

The study found that a simple cognitive task as early as four days after a brain injury activated the region that improves memory function and can guard against two hallmarks of concussion — depression and anxiety.

“Right now, if you have a concussion the directive is to have complete physical and cognitive rest, no activities, no social interaction, to let your brain rest and recover from the energy crisis as a result of the injury,” said SMU physiologist Sushmita Purkayastha, who led the research, which was funded by the Texas Institute for Brain Injury and Repair at UT Southwestern Medical Center, Dallas.

“But what we saw, the student athletes came in on approximately the third day of their concussion and the test was not stressful for them. None of the patients complained about any symptom aggravation as a result of the task. Their parasympathetic nervous system — which regulates automatic responses such as heart rate when the body is at rest — was activated, which is a good sign,” said Purkayastha, an assistant professor in the Department of Applied Physiology and Wellness.

The parasympathetic nervous system is associated with better memory function and implicated in better cardiovascular function. It also helps to regulates stress, depression and anxiety — and those are very common symptoms after a concussion.

“People in the absolute rest phase after concussion often experience depression,” Purkayastha added. “In the case of concussion, cutting people off from their social circle when we say ‘no screen time’ — particularly the young generation with their cell phones and iPads — they will just get more depressed and anxious. So maybe we need to rethink current rehabilitation strategy.”

The new study addresses the lack of research upon which to develop science- and data-based treatment for concussion. The findings emerged when the research team measured variations in heart rate variability among athletes with concussions while responding to simple problem-solving and decision-making tasks.

While we normally think of our heart rate as a steady phenomenon, in actuality the interval varies and is somewhat irregular — and that is desirable and healthy. High heart rate variability is an indicator of sound cardiovascular health. Higher levels of variability indicate that physiological processes are better controlled and functioning as they should, such as during stressful (both physical and challenging mental tasks) or emotional situations.

Concussed athletes normally have lowered heart rate variability.

For the new study, Purkayastha and her team administered a fairly simple cognitive task to athletes with concussions. During the task, the athletes recorded a significant increase in heart rate variability.

The study is the first of its kind to examine heart rate variability in college athletes with concussions during a cognitive task.

The findings suggest that a small measure of brain work could be beneficial, said co-investigator and neuro-rehabilitation specialist Kathleen R. Bell, a physician at UT Southwestern.

“This type of research will change fundamentally the way that patients with sports and other concussions are treated,” said Bell, who works with brain injury patients and is Chair of Physical Medicine and Rehabilitation at UT Southwestern. “Understanding the basic physiology of brain injury and repair is the key to enhancing recovery for our young people after concussion.”

The researchers reported their findings in the peer-reviewed Journal of Head Trauma Rehabilitation, in the article “Reduced resting and increased elevation of heart rate variability with cognitive task performance in concussed athletes.”

Co-authors from SMU Simmons School include Mu Huang and Justin Frantz; Peter F. Davis and Scott L. Davis, from SMU’s Department of Applied Physiology and Wellness; Gilbert Moralez, Texas Health Presbyterian Hospital, Dallas; and Tonia Sabo, UT Southwestern.

Concussion symptom improved with simple brain activity
Volunteer subjects for the study were 46 NCAA Division I and recreational athletes who participate in contact-collision sports. Of those, 23 had a physician-diagnosed sports-related concussion in accordance with NCAA diagnostic criteria. Each of them underwent the research testing within approximately three to four days after their injury.

Not surprisingly, compared to the athletes in the control group who didn’t have concussions, the athletes with concussions entered answers that were largely incorrect.

More importantly, though, the researchers observed a positive physiological response to the task in the form of increased heart rate variability, said Purkayastha.

“It’s true that the concussed group gave wrong answers for the most part. More important, however, is the fact that during the task their heart rate variability improved,” she said. “That was most likely due to the enhancement of their brain activity, which led to better regulation. It seems that engaging in a cognitive task is crucial for recovery.”

Heart rate variability is a normal physiological process of the heart. It makes possible a testing method as noninvasive as taking a patient’s blood pressure, pulse or temperature. In the clinical field, measuring heart rate variability is an increasingly common screening tool to see if involuntary responses in the body are functioning and being regulated properly by the autonomic nervous system.

The parasympathetic is blunted or dampened by concussion
Abnormal fluctuations in heart rate variability are associated with certain conditions before symptoms are otherwise noticeable.

Monitoring heart rate variability measures the normal synchronized contractions of the heart’s atriums and ventricles in response to natural electrical impulses that rhythmically move across the muscles of the heart.

After a concussion, an abnormal and unhealthy decline in heart rate variability is observed in the parasympathetic nervous system, a branch of the autonomic nervous system. The parasympathetic is in effect blunted or dampened after a concussion, said Purkayastha.

As expected, in the current study, heart rate variability was lower among the athletes with concussions than those without.

New findings add evidence suggesting experts rethink rehab
But that changed during the simple cognitive task. For the athletes with concussions, their heart rate variability increased, indicating the parasympathetic nervous system was activated by the task.

Heart rate variability between the concussed and the controls was comparable during the cognitive task, the researchers said in their study.

“This suggests that maybe we need to rethink rehabilitation after someone has a concussion,” Purkayastha said. — Margaret Allen, SMU

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People who deeply grasp the pain or happiness of others also process music differently in the brain

These areas of the brain uniquely activate in people with higher empathy when they listen to music. (Credit: SMU, UCLA)

Higher empathy people appear to process music like a pleasurable proxy for a human encounter — in the brain regions for reward, social awareness and regulation of social emotions.

People with higher empathy differ from others in the way their brains process music, according to a study by researchers at Southern Methodist University, Dallas and UCLA.

The researchers found that compared to low empathy people, those with higher empathy process familiar music with greater involvement of the reward system of the brain, as well as in areas responsible for processing social information.

“High-empathy and low-empathy people share a lot in common when listening to music, including roughly equivalent involvement in the regions of the brain related to auditory, emotion, and sensory-motor processing,” said lead author Zachary Wallmark, an assistant professor in the SMU Meadows School of the Arts.

But there is at least one significant difference.

Highly empathic people process familiar music with greater involvement of the brain’s social circuitry, such as the areas activated when feeling empathy for others. They also seem to experience a greater degree of pleasure in listening, as indicated by increased activation of the reward system.

“This may indicate that music is being perceived weakly as a kind of social entity, as an imagined or virtual human presence,” Wallmark said.

Researchers in 2014 reported that about 20 percent of the population is highly empathic. These are people who are especially sensitive and respond strongly to social and emotional stimuli.

The SMU-UCLA study is the first to find evidence supporting a neural account of the music-empathy connection. Also, it is among the first to use functional magnetic resonance imaging (fMRI) to explore how empathy affects the way we perceive music.

The new study indicates that among higher-empathy people, at least, music is not solely a form of artistic expression.

“If music was not related to how we process the social world, then we likely would have seen no significant difference in the brain activation between high-empathy and low-empathy people,” said Wallmark, who is director of the MuSci Lab at SMU, an interdisciplinary research collective that studies — among other things — how music affects the brain.

“This tells us that over and above appreciating music as high art, music is about humans interacting with other humans and trying to understand and communicate with each other,” he said.

This may seem obvious.

“But in our culture we have a whole elaborate system of music education and music thinking that treats music as a sort of disembodied object of aesthetic contemplation,” Wallmark said. “In contrast, the results of our study help explain how music connects us to others. This could have implications for how we understand the function of music in our world, and possibly in our evolutionary past.”

The researchers reported their findings in the peer-reviewed journal Frontiers in Behavioral Neuroscience, in the article “Neurophysiological effects of trait empathy in music listening.”

The co-authors are Choi Deblieck, with the University of Leuven, Belgium, and Marco Iacoboni, UCLA. The research was carried out at the Ahmanson-Lovelace Brain Mapping Center at UCLA.

“The study shows on one hand the power of empathy in modulating music perception, a phenomenon that reminds us of the original roots of the concept of empathy — ‘feeling into’ a piece of art,” said senior author Marco Iacoboni, a neuroscientist at the UCLA Semel Institute for Neuroscience and Human Behavior.

“On the other hand,” Iacoboni said, “the study shows the power of music in triggering the same complex social processes at work in the brain that are at play during human social interactions.”

Comparison of brain scans showed distinctive differences based on empathy
Participants were 20 UCLA undergraduate students. They were each scanned in an MRI machine while listening to excerpts of music that were either familiar or unfamiliar to them, and that they either liked or disliked. The familiar music was selected by participants prior to the scan.

Afterward each person completed a standard questionnaire to assess individual differences in empathy — for example, frequently feeling sympathy for others in distress, or imagining oneself in another’s shoes.

The researchers then did controlled comparisons to see which areas of the brain during music listening are correlated with empathy.

Analysis of the brain scans showed that high empathizers experienced more activity in the dorsal striatum, part of the brain’s reward system, when listening to familiar music, whether they liked the music or not.

The reward system is related to pleasure and other positive emotions. Malfunction of the area can lead to addictive behaviors.

Empathic people process music with involvement of social cognitive circuitry
In addition, the brain scans of higher empathy people in the study also recorded greater activation in medial and lateral areas of the prefrontal cortex that are responsible for processing the social world, and in the temporoparietal junction, which is critical to analyzing and understanding others’ behaviors and intentions.

Typically, those areas of the brain are activated when people are interacting with, or thinking about, other people. Observing their correlation with empathy during music listening might indicate that music to these listeners functions as a proxy for a human encounter.

Beyond analysis of the brain scans, the researchers also looked at purely behavioral data — answers to a survey asking the listeners to rate the music afterward.

Those data also indicated that higher empathy people were more passionate in their musical likes and dislikes, such as showing a stronger preference for unfamiliar music.

Precise neurophysiological relationship between empathy and music is largely unexplored
A large body of research has focused on the cognitive neuroscience of empathy — how we understand and experience the thoughts and emotions of other people. Studies point to a number of areas of the prefrontal, insular, and cingulate cortices as being relevant to what brain scientists refer to as social cognition.

Studies have shown that activation of the social circuitry in the brain varies from individual to individual. People with more empathic personalities show increased activity in those areas when performing socially relevant tasks, including watching a needle penetrating skin, listening to non-verbal vocal sounds, observing emotional facial expressions, or seeing a loved one in pain.

In the field of music psychology, a number of recent studies have suggested that empathy is related to intensity of emotional responses to music, listening style, and musical preferences — for example, empathic people are more likely to enjoy sad music.

“This study contributes to a growing body of evidence,” Wallmark said, “that music processing may piggyback upon cognitive mechanisms that originally evolved to facilitate social interaction.” — Margaret Allen, SMU

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Culture, Society & Family Feature Health & Medicine Researcher news SMU In The News Student researchers

SAPIENS: Why Aid Remains Out of Reach for Some Rohingya Refugees

Even with the right to health care secured, medical assistance is elusive for urban refugees in India.

The anthropology publication SAPIENS has published an article by SMU doctoral candidate Ashvina Patel.

SAPIENS is an editorially independent publication of the Wenner-Gren Foundation for Anthropological Research Inc., which is dedicated to popularizing anthropology to a broad audience.

The article, “Why Aid Remains Out of Reach for Some Rohingya Refugees,” published May 17, 2018.

The article resulted from Patel’s 11-month stay in New Delhi, India, in which she interviewed residents of three urban refugee settlements. The purpose was to understand how issues of geopolitics and domestic policy inform various types of human insecurity for refugees.

Patel is currently a visiting student fellow at Oxford University’s Refugee Studies Centre, where she is developing further publications on Rohingya refugee displacement.

She is a doctoral candidate in SMU’s Department of Anthropology. Patel holds an M.A. degree in Cultural Anthropology from SMU and an M.A. in Religion from University of Hawaii, Manoa. As a doctoral student, her research focuses on issues of human insecurity among Rohingya refugees in the context of American resettlement as well as within New Delhi, India as urban refugees. Her research work focuses specifically on defining the subjective experience of human insecurity and how various forms of insecurity are informed by statelessness.

Patel is a student of SMU anthropology professor Caroline Brettell, an internationally recognized immigration expert and Ruth Collins Altshuler Professor and Director of the Interdisciplinary Institute. Brettell is a member of the American Academy of Arts and Sciences.

A private operating foundation, Wenner-Gren is dedicated to the advancement of anthropology throughout the world. Located in New York City, it is one of the major funding sources for international anthropological research and is actively engaged with the anthropological community through its varied grant, fellowship, networking, conference and symposia programs.

It founded and continues to publish the international journal Current Anthropology, and disseminates the results of its symposia through open-access supplementary issues of this journal. The Foundation works to support all branches of anthropology and closely related disciplines concerned with human biological and cultural origins, development, and variation.

Read the full article.

EXCERPT:

From the field notes
of SMU PhD candidate Ashvina Patel
Ameena (a pseudonym) is a 25-year-old Rohingya refugee in New Delhi, India, who is seven months pregnant with twins. Her face is gaunt. Often there isn’t enough food at home for her family of five. Nestled among other shanty houses, her home is made of bamboo with scrap boards as paneling; a tattered piece of cloth serves as the front door. Recently, the monsoon rains caused her to slip and fall. Now one of the babies in her womb is not moving. She knows she needs to see a doctor, but she cannot afford one.

When Ameena fled acts of genocide perpetrated by her own government of Myanmar in 2012, she and her husband came to New Delhi. They both suffer from debilitating deformities due to polio, and they heard that the United Nations High Commissioner for Refugees (UNHCR) office in New Delhi was helping Rohingya refugees. The UNHCR partners with the Indian government to provide free aid to help people obtain an education, a livelihood, and health care.

But as Ameena and others would learn, being offered access to aid isn’t always enough. Barriers to procuring those free resources often leave urban refugees to fend for themselves; many find they have to negotiate a system that inadvertently creates obstacles to reaching that aid.

Having spent 11 months with the Rohingya community in India from 2015 to 2017, I repeatedly saw how aid missed its intended target. As the UNHCR creates solutions to challenges that refugees face, these solutions can also serve as a catalyst for new obstacles or deepen already existing insecurities by creating additional barriers that are financial, linguistic, cultural, or exploitative. The UNHCR does a lot of good, but the organization could do a better job addressing challenges refugees face in accessing the services to which they are permitted.

Read the full article.

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Culture, Society & Family Health & Medicine Researcher news SMU In The News Videos

Fox4WARD: Knowing how our partner is feeling

Fox 4 journalist Dan Godwin interviewed family psychologist Chrystyna D. Kouros, an associate professor in the SMU Department of Psychology, about her latest research on couples.

Lead author on the new study, Kouros and her co-author, relationship psychologist Lauren M. Papp at the University of Wisconsin-Madison, found that couples do poorly when it comes to knowing their partner is sad, lonely or feeling down.

Kouros and Papp reported their findings in the peer-reviewed journal Family Process, in the article “Couples’ Perceptions of Each Other’s Daily Affect: Empathic Accuracy, Assumed Similarity, and Indirect Accuracy.”

Godwin’s segment, “Knowing how our partner is feeling,” aired March 11 on Fox 4’s 10 p.m. Sunday news segment Fox4WARD.

Watch the full segment on Fox 4.

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Culture, Society & Family Feature Health & Medicine

New study finds couples do poorly at knowing when their partner is sad or feeling down

Spouses are the primary source of social support to one another, so it’s important to their relationship they stay attuned to each other’s emotions.

How well do couples pick up on one another’s feelings? Pretty well, when the emotion is happiness, says a psychologist at Southern Methodist University, Dallas.

But a new study finds that couples do poorly when it comes to knowing their partner is sad, lonely or feeling down.

“We found that when it comes to the normal ebb and flow of daily emotions, couples aren’t picking up on those occasional changes in ‘soft negative’ emotions like sadness or feeling down,” said family psychologist Chrystyna D. Kouros, lead author on the study. “They might be missing important emotional clues.”

Even when a negative mood isn’t related to the relationship, it ultimately can be harmful to a couple, said Kouros, an associate professor in the SMU Department of Psychology. A spouse is usually the primary social supporter for a person.

“Failing to pick up on negative feelings one or two days is not a big deal,” she said. “But if this accumulates, then down the road it could become a problem for the relationship. It’s these missed opportunities to be offering support or talking it out that can compound over time to negatively affect a relationship.”

The finding is consistent with other research that has shown that couples tend to assume their partner feels the same way they are feeling, or thinks the same way they do, Kouros said.

But when it comes to sadness and loneliness, couples need to be on the look-out for tell-tale signs. Some people are better at this process of “empathic accuracy” — picking up on a partner’s emotions — than others.

“With empathic accuracy you’re relying on clues from your partner to figure out their mood,” Kouros said. “Assumed similarity, on the other hand, is when you just assume your partner feels the same way you do. Sometimes you might be right, because the two of you actually do feel the same, but not because you were really in tune with your partner.”

Co-author on the study is relationship psychologist Lauren M. Papp at the University of Wisconsin-Madison.

Kouros and Papp reported their findings in the peer-reviewed journal Family Process, in the article “Couples’ Perceptions of Each Other’s Daily Affect: Empathic Accuracy, Assumed Similarity, and Indirect Accuracy.”

Couples should assume less about one another, observe more
The problem isn’t one for which couples need to seek therapy, Kouros said. Instead, she advises couples to stop assuming they know what their partner is feeling. Also, pay more attention to your partner, and communicate more.

“I suggest couples put a little more effort into paying attention to their partner — be more mindful and in the moment when you are with your partner,” she said.

She cautions, however, against becoming annoying by constantly asking how the other is feeling, or if something is wrong.

“Obviously you could take it too far,” Kouros said. “If you sense that your partner’s mood is a little different than usual, you can just simply ask how their day was, or maybe you don’t even bring it up, you just say instead ‘Let me pick up dinner tonight’ or ‘I’ll put the kids to bed tonight.’”

Even so, partners shouldn’t assume their spouse is a mind-reader, expecting them to pick up on their emotions. “If there’s something you want to talk about, then communicate that. It’s a two-way street,” she said. “It’s not just your partner’s responsibility.”

Participants were 51 couples who completed daily diaries about their mood and the mood of their partner for seven consecutive nights. The study veers from conventional approaches to the topic, which have relied on interviewing couples in a lab setting about feelings related to conflicts in their relationship.

Kouros and Papp will also present the research findings March 23 at the 2018 biennial meeting of the Society for Research in Human Development. — Margaret Allen, SMU