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Allostasis: A New Paradigm to Explain Arousal Pathology

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homeostasis versus allostasis mechanisms of allostasis allostatic regulation of the immune response regulation of arousal pathology from chronic arousal definitions of health and approaches to therapeutics hypertension / psychoneuriommunology / iatrogenesis / health (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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... Touch can create bio-feedback loops that help develop and learn to develop new or update less precise priors by altering the setpoint in crucial survival demands (Rossettini et al., 2022). This viewpoint was initially proposed by Sterling and Eyer (1988) and has been expanding to include the integration of active inference to interception, regulation of homoeostasis and allostasis, all based on recent advances in anatomical knowledge, empirical models, and computational neuroscience (Stephan et al., 2016;Fotopoulou et al., 2022). When developing a prior, brain regions such as the AIC, Anterior cingulate cortex (ACC), orbitofrontal cortex (OFC), and subgenual cortex (SGC) will generate allostatic predictions to embody a generative model of the current input Corcoran et al., 2020;Tschantz et al., 2022). ...
... They can do the movement, even if the HCP is physically doing the action for them, such as a passive joint examination. All areas mentioned above connect to the granular layer IV of the primary interoceptive insular cortex allowing the integrative modulation of homoeostatic beliefs (Sterling and Eyer, 1988;Fotopoulou et al., 2022). These assumptions are sustained and expanded upon from the recognised anatomical and hierarchical structure of laminar patterns in Macaque monkeys . ...
... Green arrows: predictions errors; Red arrows: predictions. Touch biofeedback loop adapted from Sterling and Eyer (1988) and Fotopoulou et al. (2022) to help modify and adjust the importance of priors through new allostatic predictions from therapeutic touch. We suggest that the AIC, ACC, SGC, and OFC create allostatic therapeutic touch predictions that underwrite interceptive prediction errors in the posterior and mid insula. ...
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Touch is recognised as crucial for survival, fostering cooperative communication, accelerating recovery, reducing hospital stays, and promoting overall wellness and the therapeutic alliance. In this hypothesis and theory paper, we present an entwined model that combines touch for alignment and active inference to explain how the brain develops "priors" necessary for the health care provider to engage with the patient effectively. We appeal to active inference to explain the empirically integrative neurophysiological and behavioural mechanisms that underwrite synchronous relationships through touch. Specifically, we offer a formal framework for understanding-and explaining-the role of therapeutic touch and hands-on care in developing a therapeutic alliance and synchrony between health care providers and their patients in musculoskeletal care. We first review the crucial importance of therapeutic touch and its clinical role in facilitating the formation of a solid therapeutic alliance and in regulating allostasis. We then consider how touch is used clinically-to promote cooperative communication, demonstrate empathy, overcome uncertainty, and infer the mental states of others-through the lens of active inference. We conclude that touch plays a crucial role in achieving successful clinical outcomes and adapting previous priors to create intertwined beliefs. The ensuing framework may help healthcare providers in the field of musculoskeletal care to use hands-on care to strengthen the therapeutic alliance, minimise prediction errors (a.k.a., free energy), and thereby promote recovery from physical and psychological impairments.
... Often called the stress hormone, cortisol regulates energycontrolling blood sugar levels, mobilizes energy to target tissues and muscles, and reduces inflammation in the body. Cortisol concentration plays a vital role in the body's stress response as an indicator of stress level [78,79]. However, when cortisol levels rise, the HPA axis slows down CRH release from the hypothalamus and ACTH from the pituitary gland, as shown in Fig. 2. As an adaptive response to a threat, the level of various hormones also changes. ...
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Stress alters neuroendocrine, autonomic, and behavioral processes to cope well with perceived threats that compromise subjective wellbeing. Just as the perception of risk can change the structure and function of brain circuitry, which may result in enduring behavioral changes. There needs to be a greater understanding of how the brain reacts to stress-related disorders and discern how the adaptation mechanisms of the central nervous system under acute stress, as well as how stress-induced adaptation mechanisms are altered under chronic stress conditions that may induce plasticity-related changes in the brain. During this interaction, the brain becomes more capable of resolving stress in a way that is either adaptive or maladaptive, leaving the most critical deficit in the emotion regulation associated with risk for pathological conditions. The essence of this associated risk involves the reciprocal influence between hypothalamic-pituitary-adrenal function, the relay nucleus within the amygdala reactivation, and the hippocampus as essential structures associated with the forebrain pathways mediating stress-induced hormones, and the gamma-aminobutyric acid neurotransmitter system as key mechanisms of regulating stress. Understanding how related emotional experiences occur on the neural level and their impact on cognition and behavior entail tracing the interaction between the hypothalamic-pituitary-adrenal axis, the hormones released by these structures, and the neuroendocrine system's reactivity to stress. The interaction between threat-sensitive brain circuitry and the neuroendocrine stress system is crucial to understanding how related emotions arise on the neural level and their impact on cognition and behavior. The hypothalamic-pituitary-adrenal axis is critical in regulating the synthesis and release of endocrine hormones through its interactions with these structures, collectively referred to as the stress response. The stress system is described in its anatomy and physiology and connections to other brain areas and endocrine systems. We explore the current evidence linking stress with pathophysiologic mechanisms implicated in stressful conditions affecting the neuronal circuitry between endocrine, metabolic, gastrointestinal, and immune systems. Examining the biopsychological contributions provides a conceptual framework for understanding the emergence of emotions and stress-related behaviors.
... In order to try to understand the ways in which individuals respond to stress, McEwen and colleagues proposed that exposure to chronic stress exerted its costs by contributing to allostatic loading. Allostasis, as originally defined by Sterling and Eyer (1988) represents the operating range through which the physiological process can adjust. This concept was further refined by McEwen and colleagues to represent the physiological and psychological responses to environmental challenges (McEwen and Stellar, 1993). ...
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Traumatic brain injury (TBI) represents a major public health concern. Although the majority of individuals that suffer mild-moderate TBI recover relatively quickly, a substantial subset of individuals experiences prolonged and debilitating symptoms. An exacerbated response to physiological and psychological stressors after TBI may mediate poor functional recovery. Individuals with TBI can suffer from poor stress tolerance, impairments in the ability to evaluate stressors, and poor initiation (and cessation) of neuroendocrine stress responses, all of which can exacerbate TBI-mediated dysfunction. Here, we pay tribute to the pioneering neuroendocrinologist Dr. Bruce McEwen by discussing the ways in which his work on stress physiology and allostatic loading impacts the TBI patient population both before and after their injuries. Specifically, we will discuss the modulatory role of hypothalamic-pituitary-adrenal axis responses immediately after TBI and later in recovery. We will also consider the impact of stressors and stress responses in promoting post-concussive syndrome and post-traumatic stress disorders, two common sequelae of TBI. Finally, we will explore the role of early life stressors, prior to brain injuries, as modulators of injury outcomes.
... The concept of homeostasis, replaced in recent years by the term allostasis, is intended as a system of adaptation to environmental variations, "stability through change" [38,53,54]. The allostatic load represents the metabolic expenditure to preserve such an adaptation. ...
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Over the years, several authors have discussed the possibility of considering somatic dysfunction (SD) as a “nosological element” detectable on palpation. There are many aspects to consider regarding the etiology and diagnosis of SD, and the literature on osteopathic issues provides details on physiological signs that characterize it, including tissue texture changes. Recent knowledge suggests that how tissue and, in particular, connective tissue, responds to osteopathic treatment may depend on the modulation of the inflammation degree. Low-grade inflammation (LGI) may act on the extracellular matrix (ECM) and on cellular elements; and these mechanisms may be mediated by biological water. With its molecules organized in structures called exclusion zones (EZ), water could explain the functioning of both healthy and injured tissues, and how they can respond to osteopathic treatment with possible EZ normalization as a result. The relationship between inflammation and DS and the mechanisms involved are described by several authors; however, this review suggests a new model relating to the characteristics of DS and to its clinical implications by linking to LGI. Tissue alterations detectable by osteopathic palpation would be mediated by body fluids and in particular by biological water which has well-defined biophysical characteristics. Research in this area is certainly still to be explored, but our suggestion seems plausible to explain many dynamics related to osteopathic treatment. We believe that this could open up a fascinating scenario of therapeutic possibilities and knowledge in the future.
... In general, opioid agonists strengthen emotions oriented toward interpersonal bonds. [15] To conclude this subsection, it should be reminded that, when providing a vulnerable or resilient phenotype, allostatic processes, understood as they were proposed and described in 1988, [16] together with genetic polymorphism, exert a significant influence on the course and severity of substance use disorders or addictive behaviors. [17] Appart from that, to hide one's own vulnerabilities can hinder the treatment. ...
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Background: Our anatomical-physiological nervous system, our beliefs, knowledge and affectivity are continuously interrelated, although they are often not well discriminated. Method: This is not a revision, but rather, a qualitative, narrative research, with inclusive and interpretative variables. Results: In practice, thoughts and feelings interwoven with actions conform the individual existential reality. The Jakob-Papez circuit of the limbic system is crucial to the processing of emotions, memories and learning. In particular, learning and memory need the integrity of the basolateral amygdala in the temporal lobe. It is indeed well known that the activity of the hippocampus and the amygdala is important when it comes to memory. This paper will also comment on how stress affects learning and especially, the so-called emotional memory, and that both aggressiveness and violence, as well as the empathetic condition can all be considered parts of the same dimension. Conclusions: One’s will, beliefs and desires, integrated within the ideological domain explain, together with neurobiology, most of one’s behaviors, including aggressiveness in general, and violence in particular. We will also emphasize that stress exposure, which has such complex effects in the mnemonic encoding, can produce profound changes in physiology and social behavior. Antecedentes y Objetivos: Se puede afirmar que la biología y la emoción deciden, y que la razón justifica. El sistema nervioso anatomo-fisiológico, las creencias, conocimiento y afectividad están continuamente interrelacionados, aunque con frecuencia no se discriminen bien. Con el presente estudio pretendemos aportar una visión psiconeurológica panorámica, esclarecedora, imparcial y actualizada de esas interrelaciones. Método: Se trata de una investigación narrativa, no una revisión, de tipo cualitativo, con variables integradoras e interpretativas. Resultados: En la práctica, tanto los pensamientos y sentimientos como las acciones conforman imbricados la realidad existencial individual. Resulta crucial el circuito de Jakob del sistema límbico para el procesamiento de las emociones, los recuerdos y el aprendizaje. En particular este último y la memoria necesitan la integridad de la amígdala basolateral del lóbulo temporal. En efecto, es bien conocida la importancia que tiene para la memoria la actividad del hipocampo y la amígdala. Comentaremos seguidamente que el estrés afecta al aprendizaje y en especial a la llamada memoria emocional, y que tanto la agresividad y la violencia, como la condición empática pueden considerarse partes de una misma dimensión. Conclusiones: La voluntad, creencias y deseos, integradas en el ámbito ideológico, explican junto con la neurobiología la mayoría de las conductas, incluyendo las agresivas en general y en particular las violentas. Enfatizaremos que la exposición al estrés, de efectos tan complejos en la codificación mnésica, puede producir cambios profundos en la fisiología y el comportamiento social.
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In the brain, the insular cortex receives a vast amount of interoceptive information, ascending through deep brain structures, from multiple visceral organs. The unique hierarchical and modular architecture of the insula suggests specialization for processing interoceptive afferents. Yet, the biological significance of the insula's neuroanatomical architecture, in relation to deep brain structures, remains obscure. In this opinion piece, we propose the Insula Hierarchical Modular Adaptive Interoception Control (IMAC) model to suggest that insula modules (granular, dysgranular and agranular), forming parallel networks with the prefrontal cortex and striatum, are specialized to form higher order interoceptive representations. These interoceptive representations are recruited in a context-dependent manner to support habitual, model-based and exploratory control of visceral organs and physiological processes. We discuss how insula interoceptive representations may give rise to conscious feelings that best explain lower order deep brain interoceptive representations, and how the insula may serve to defend the body and mind against pathological depression.
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Angiotensin II and aldosterone increase in response to sodium deficiency to promote sodium and water conservation. In addition, they may act synergistically to arouse a sodium appetite. If so, then blockade of endogenous angiotensin should decrease the appetite. In experiments reported here, captopril (SQ 14,225) was given peripherally to rats to block conversion of angiotensin I to angiotensin II. It both enhanced and suppressed sodium depletion-induced sodium appetite. The appetite was suppressed when captopril was given in high doses, which block conversion centrally as well as peripherally. The same doses of captopril had no effect on urinary sodium excretion or on sodium appetite aroused by mineralocorticoid treatment. Low doses, which block conversion only in the periphery, enhanced salt intake elicited by depletion, and the enhancement was abolished by captopril given directly into the brain. Therefore the enhancement was probably due to a captopril-induced increase of peripheral angiotensin I, which gained access to the brain and was converted there to angiotensin II.
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Truisms are, of course, self evident. In spite of their obviousness we need to reconsider some in order to appreciate understanding that we take for granted and to remind ourselves of the value of particular approaches we use in our research on brain function. It seems evident to me that understanding behavior and higher order brain function reduces to knowing the rules governing the flow of information in neural networks. Biochemical, molecular, cellular and pharmocological events affect brain function by rising to modulate this flow of infomation in neural circuits. Given these axioms it is, therefore, important to learn the organization of the brain’s neural networks.
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The author presents a discussion of the steady states (homeostases) of the body, with the explanation, so far as such is possible, of the mechanisms controlling such conditions. The account is closed with analogies between the regulation of the body and the regulation of social processes. Brief bibliography. (PsycINFO Database Record (c) 2012 APA, all rights reserved)