Increased spontaneous fronto-central oscillatory power during eye closing in patients with multiple somatic symptoms, 2022, Xiquan et al

[Andy]

Highlights
• Resting-state EEGs for different states were associated with somatic symptom severity.
• MSS patients were defined according to the scoring of PHQ-15.
• MSS patients showed increased powers in low-beta and high-gamma band during eye-closing.
• Higher scores in depression were associated with a severe somatic symptom.
• MSS patients demonstrated day-dreaming and difficulties in describing and identifying emotions.

Abstract

Functional somatic symptoms (FSS) are typically associated with excessive thoughts, feelings and behaviors related to the physical symptoms whether these symptoms are unequivocally associated with a diagnosed medical condition. However, less evidence is available concerning the neurocognitive deficits underlying these features of FSS. This study aimed to examine the resting-state oscillatory activities during both eye-opening and eye-closure states in individuals with FSS. Sixty-six FSS patients screened with PHQ-15 received two 10-minute sessions of EEG assessments. All completed clinical measurements on depression, anxiety, and psychological measurements on personality traits and alexithymia. Patients scoring high on PHQ-15 (the multiple somatic symptom (MSS) or SS-high group) demonstrated increased powers in central channels (C3 and C4) in low-beta band and in the left-frontal channel (F3) in high-gamma band, during eye-closure states. Patients with higher scores in depression were more likely to be classified as the SS-high group. SS-high patients demonstrated increased difficulties in describing and identifying emotions, and less reduced day-dreaming. The combined findings in increased fronto-central high-frequency activities and alexithymia measures suggest MSS patients are associated with enhanced internally-oriented thinking and cognitive simulation which may lead to intensified feelings of simulated events and misattribution of symptoms. Future treatments should focus on eliminating cognitive bias and enhancing accuracy in interoceptive awareness.

Paywall, https://www.sciencedirect.com/science/article/abs/pii/S0925492722000506

 

[JemPD]

Future treatments should focus on eliminating cognitive bias and enhancing accuracy in interoceptive awareness.

And how, pray tell, does a therapist help someone enhance their interoceptive accuracy? Since they are not inside the person's body how can they have the arrogance to think they can tell the person who IS inside, how to accurately interpret it!?

Patients with higher scores in depression were more likely to be classified as the SS-high group.

Patients with higher scores in depression the SS high group were more likely to be classified as the SS-high group depressed. .... With a lot of life-affecting symptoms, guess what its quite depressing.

How many more years do we have to suffer through such drivel

The way the frame every sentence reveals their bias.

EDITED - to change 'awareness' in my first sentence, to 'accuracy'

 

[CRG]

And how, pray tell, does a therapist help someone enhance their interoceptive awareness? Since they are not inside the person's body how can they have the arrogance to think they can tell the person who IS inside, how to accurately interpret it!?

Interoception models are fairly simple, just awareness of basic functions, breathing and heart rate are the usual targets: Research on Interoceptive Awareness Training

"Interoceptive awareness is the awareness of inner body sensations, involving the sensory process of receiving, accessing, and appraising internal bodily signals (Craig, 2009). Interoceptive awareness is fundamental to mindfulness-based approaches, involving focused present-moment awareness on internal sensations, most often introduced by attending to the sensations of the breath (inhaling and exhaling), or by engaging in a body scan. Interoception is recognized as a possible mechanism underlying mindfulness-based approaches (Farb et al., 2015; Garland, 2016), and learning interoceptive awareness skills may improve well-being and enhance capacity for emotion regulation (de Jong, et al., 2016; Price, et al., 2018)."

 

[JemPD]

I have said before that sexual abuse is not a specific abuse, it can range from name calling to serious physical attack with suffocation. In fact all abuse has a wide range of seriousness.

oh silly me, i meant interoceptive accuracy, not awareness. have edited original post accordingly.

I know what interoception is, i enjoy mindfulness meditation. But other than heart rate & breathing, which can be accessed/observed from outside, no therapist can tell me whether what i am experiencing inside my own body - my own bodily sensation, is 'accurate' or not. It is by nature a subjective experience. Was what i meant.
Interoceptive awareness is a different issue. sorry my typing error was misleading there

 

[CRG]

Measure of "interoceptive accuracy" developed by the same group as the paper above: Multidimensional Interoception and Autistic Traits Across life Stages: Evidence From a Novel Eye-tracking Task

"Abundant studies have suggested that neurotypical individuals have an implicit awareness of heartbeats, which affects higher-order cognitions such as memory (Chua & Bliss-Moreau, 2016; Umeda et al., 2016), emotion regu-lation (Fuestoes et al., 2013), empathy (Fukushima et al., 2011; Mul et al., 2018) and self-awareness (Seth, 2013; Shah, 2016).

I don't know how relevant this might be to ME/CFS but if we allow that ME/CFS does involve neurological deficits then it is an interesting speculation that some of the symptomology of ME/CFS might be mediated by cognitive impairments.

 

[Jonathan Edwards]

Interoception models are fairly simple, just awareness of basic functions, breathing and heart rate are the usual targets:

Yes but we can all be aware of those. The issue is supposed to be misinterpretation of interoceptive signals contributing to illness. How can a therapist know there is misinterpretation and how could they possibly know how to tell people how to change that misinterpretation?

There is a naive assumption that if internal neural regulation is off whack psychologists can put it back on whack by telling people what to do. Since we have not the slightest idea why it is off whack if it is there is no possibility of this being realistic.

The whole thing is bullshit surely?

 

[Ariel]

There is a naive assumption that if internal neural regulation is off whack psychologists can put it back on whack by telling people what to do. Since we have not the slightest idea why it is off whack if it is there is possibility of this being realistic.

The whole thing is bullshit surely?

I have never understood how people managed to convince anyone of this, that they were somehow going to talk people out of some hypothesised form of dysregulation. It seems people just don't even think about whether it sounds plausible - instead it has been sold as a form of "common sense".

I hope something or someone can break the spell. I only see more and more belief in these kinds of ideas by the general public as time goes on, sadly. I wish long covid nonsense could be a wake-up call for the public and for medicine. We seem doomed to these kinds of ideas that aren't even questioned for some time to come.

 

[JemPD]

How can a therapist know there is misinterpretation and how could they possibly know how to tell people how to change that misinterpretation?

yes this is what i was trying to say thankyou for expressing it coherently

I hope something or someone can break the spell. I only see more and more belief in these kinds of ideas by the general public as time goes on, sadly. I wish long covid nonsense could be a wake-up call for the public and for medicine. We seem doomed to these kinds of ideas that aren't even questioned for some time to come.

The trouble is it falls on welcome ears/fertile ground.

Like all the other BPS crap its just another version of 'youre doing it wrong'

- your thoughts are wrong/ your feelings are wrong / your behaviour is wrong,

& now we increasingly have 'your internal senses/interpretation of your senses is wrong'.

whatever it is, its in you, you're doing something wrong, & we just need to find what it is so we can get someone to teach you how to do it right.

If the sufferer is basically just 'doing it wrong', that idea is so much easier for the average person to live with, than the thought that one day you might get a mild cold/covid/flu/tummy bug... and end up with all kinds of debilitating life-altering problems that 'the doctors' dont understand and cant fix.

Who wouldnt want that to be the sufferers fault?

''We' (as healthy people/people with well recognised& understood conditions) can feel sorry for them 'the poor dears' with these 'psychosomatic thingys', but it wont ever happen to us, because we just instinctively know how to do 'it' right'.

It's the 'it cant happen to me' internal defense, & these ideas support that, which is why (imho) they are accepted unquestioningly

 

[Lilas]

Exactly. In short, these people look at patients as objects not subjects in their own right. To them, we are mind, emotional and even sensory misfits (and what else?!) Poor us, without too much intelligence, almost incapable of thinking by ourselves and coping properly. We have a urgent need for re-education, of all human dimensions if possible, because we are far from being as "adapted" as them, who imagine themselves to know everything and having for all rational only their unproven theories.So ridiculous, but unfortunately real, and we suffer the opprobrium of it.

 

[JemPD]

exactly @Lilas and in fine English too if i may say so. Opprobrium is a fabulous word!

 

[Sean]

The way the frame every sentence reveals their bias.

Yep. A solid example of how a bias can thoroughly contaminate every single assumption, inference, extrapolation, and interpretation in an argument.

whatever it is, its in you, you're doing something wrong, & we just need to find what it is so we can get someone to teach you how to do it right.

This is what happens when falsification is no longer a methodological requirement.

It is impossible for us to prove we are doing it 'right', or at least genuinely trying our best. And impossible for clinicians to prove we are not.

So all we are left with is a raw power game. And they hold 99% of those cards.

 

[Snow Leopard]

Yes but we can all be aware of those. The issue is supposed to be misinterpretation of interoceptive signals contributing to illness. How can a therapist know there is misinterpretation and how could they possibly know how to tell people how to change that misinterpretation?

There is a naive assumption that if internal neural regulation is off whack psychologists can put it back on whack by telling people what to do. Since we have not the slightest idea why it is off whack if it is there is no possibility of this being realistic.

The whole thing is bullshit surely?

The people who talk about "interecoptive accuracy" do studies about whether people can accurately guess their heart rate, despite the fact that this form of interoception is mostly irrelevant to day to day living. (and hence has had minimal evolutionary selection to be accurate)

For people with FSS or CS or whatever, they then conclude that because the individuals were bad at gauging their heart rate, then they must also be inaccurate at gauging other forms of interoception such as pain. (you can see where this bullshit hypothesis is leading...)

 

[CRG]

Yes but we can all be aware of those. The issue is supposed to be misinterpretation of interoceptive signals contributing to illness. How can a therapist know there is misinterpretation and how could they possibly know how to tell people how to change that misinterpretation?

There is a naive assumption that if internal neural regulation is off whack psychologists can put it back on whack by telling people what to do. Since we have not the slightest idea why it is off whack if it is there is no possibility of this being realistic.

The whole thing is bullshit surely?

I think at this stage I'd go for improbable rather than implausible. The abstract doesn't make it clear what treatment objectives the current paper envisages but I don't think it is an unreasonable proposition that: a) poor ability to consciously approximate the timing of heartbeats is evidence of a cognitive deficit, b) that cognitive deficit whether of developmental or insult cause is characterised by missing or undeveloped neural communication, c) that specific cognitive training may stimulate the growth of new or alternative neural pathways which may in turn increase capacity that has been lost through insult or, to add capacity that had not previously developed.

Whether that proposition is open to falsifiable hypothesis I'm not sure but it seems worthy of investigation. It also seems to me to be fundamentally different to the propositions by Sharpe, White etc regarding ME/CFS where they relied on a model of deconditioning that was to be cured simply by re-conditioning, there was no acknowledgement of neural insult or impaired neural development, it was just a case of the body globally needing to be 'reset' and everything that previously functioned would start working again in the way it did before. At the very least expectations of what therapy could achieve would wildly different in following the above proposition where building new neural pathways, as in say Stroke, is understood to be challenging and results varied.

Where the problem of 'off whack' looms large is in the case where there is a continued source of insult, and that might apply to ME/CFS; rebuilding or building new circuits isn't going to help if those circuits get fused at inception. But where there is no ongoing insult I don't see that therapy would be dependent on knowing the precise nature of what is wrong - if someone has difficultly speaking following stroke we don't have to know the exact circuitry that has been damaged before speech therapy can be started. Of course it is an open question as to whether practising at getting better at estimating heart rate is equivalent to speech therapy.