Bodily Responses Research Articles

Ontogenetic rules for the molecular diversification of hypothalamic neurons.

The hypothalamus is an evolutionarily conserved endocrine interface that, among other roles, links central homeostatic control to adaptive bodily responses by releasing hormones and neuropeptides from its many neuronal subtypes. In its preoptic, anterior, tuberal and mammillary subdivisions, a kaleidoscope of magnocellular and parvocellular neuroendocrine command neurons, local-circuit neurons, and neurons that project to extrahypothalamic areas are intermingled in partially overlapping patches of nuclei. Molecular fingerprinting has produced data of unprecedented mass and depth to distinguish and even to predict the synaptic and endocrine competences, connectivity and stimulus selectivity of many neuronal modalities. These new insights support eminent studies from the past century but challenge others on the molecular rules that shape the developmental segregation of hypothalamic neuronal subtypes and their use of morphogenic cues for terminal differentiation. Here, we integrate single-cell RNA sequencing studies with those of mouse genetics and endocrinology to describe key stages of hypothalamus development, including local neurogenesis, the direct terminal differentiation of glutamatergic neurons, transition cascades for GABAergic and GABAergic cell-derived dopamine cells, waves of local neuronal migration, and sequential enrichment in neuropeptides and hormones. We particularly emphasize how transcription factors determine neuronal identity and, consequently, circuit architecture, and whether their deviations triggered by environmental factors and hormones provoke neuroendocrine illnesses.

Interindividual differences in interoception modulate behavior and brain responses in emotional inference

Emotional experiences are proposed to arise from contextualized perception of bodily responses, also referred to as interoceptive inferences. The recognition of emotions benefits from adequate access to one's own interoceptive information. However, direct empirical evidence of interoceptive inferences and their neural basis is still lacking. In the present fMRI study healthy volunteers performed a probabilistic emotion classification task with videotaped dynamically unfolding facial expressions. In a first step, we aimed to determine functional areas involved in the processing of dynamically unfolding emotional expressions. We then tested whether individuals with higher interoceptive accuracy (IAcc), as assessed by the Heartbeat detection task (HDT), or higher interoceptive sensitivity (IS), as assessed by the Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2), benefit more from the contextually given likelihood of emotional valence and whether brain regions reflecting individual IAcc and/or IS play a role in this. Individuals with higher IS benefitted more from the biased probability of emotional valence. Brain responses to more predictable emotions elicited a bilateral activity pattern comprising the inferior frontal gyrus and the posterior insula. Importantly, individual IAcc scores positively covaried with brain responses to more surprising and less predictable emotional expressions in the insula and caudate nucleus. We show for the first time that IAcc score is associated with enhanced processing of interoceptive prediction errors, particularly in the anterior insula. A higher IS score seems more likely to be associated with a stronger weighting of attention to interoceptive changes processed by the posterior insula and ventral prefrontal cortex.

Negative Requests Within Hair Salons: Grammar and Embodiment in Action Formation.

Although requests constitute a type of action that have been widely discussed within conversation analysis-oriented work, they have only recently begun to be explored in relation to the situated and multimodal dimensions in which they occur. The contribution of this paper resides in the integration of bodily-visual conduct (gaze and facial expression, gesture and locomotion, object manipulation) into a more grammatical account of requesting. Drawing on video recordings collected in two different hair salons located in the French-speaking part of Switzerland and in France (23 h in total), this paper analyzes clients’ negative requests by exploring how they interface with the participants’ embodied conducts. Contrary to what the literature describes for positively formulated requests, with negative requests clients challenge an expectable next action (or ongoing action) by the hairdresser. One linguistic format constitutes the focus of this article, roughly glossable as ‘You don’t do [action X] too much (huh)’. Our analysis of a consistent collection of such formatted turns will show that clients present them (and hairdressers tend to treat them) in different ways, depending on how they relate to embodied conduct: When these turns are used by the client as instructions, they are accompanied by manipulations of the client’s own hair and tend to occur toward the initial phase of the encounter, at a stage when hairdressers and clients collaboratively negotiate the service in prospect. When uttered as directives, these turns are not accompanied by any touching practices from the client and are typically observable in subsequent phases of the encounter, making relevant an immediate linguistic or/and bodily response from the professional, as shown by the client who is actively pursuing mutual gaze with him/her. Therefore, an action cannot be distinguished from another on the basis of the turn format alone: Its sequential placement and the participants’ co-occurring embodied conduct contribute to its situated and shared understanding. By analyzing the clients’ use of a specific linguistic format conjointly with the deployment of specific embodied resources, this study will advance our understanding of how verbal resources and embodiment operate in concert with each other in the formation and understanding of actions, thereby feeding into new areas of research on the grammar-body interface.

Critical care nurses' perception of patient involvement in care: A qualitative focus group.

Patient involvement in care in the intensive care unit (ICU) is complex. Knowledge about the nature and extent of patient involvement in the Intensive care unit is scarce. The aim of the study was to explore the critical care nursing staff's perception of patient involvement in their care in the ICU. A phenomenological, hermeneutic research study was carried out using qualitative data. Data were collected in two focus group interviews analysed using Ricoeur's theory of interpretation. The study was conducted in a level 2 medical-surgical 8-bed ICU in a regional hospital in Southern Denmark. Critical care nurses found it important to maintain involvement in intensive care. Depending on the patient's ability to partake in care, approaches for patient involvement ranged from (1) continually adjusting care activities according to the patient's bodily responses, (2) formation of a relationship with the patient to enable personalized care and (3) making room for self-determined care progressing with the patient's recovery. Critical care nurses' perception of patient involvement depended on the patient's level of consciousness. When unconscious, patient involvement was possible but took a physical approach. However, the power inequality in the nurse-patient relationship must be expressed if patient involvement in the ICU is to take place. Results suggest that nurses' perception of patient involvement in the ICU depends on the patient's level of consciousness. Patient involvement may be possible even when the patient is unconscious but it takes a more physical approach. It is essential that the power inequality in the nurse-patient relationship must be expressed if patient involvement in the ICU is to take place.

Detecting Physiological Responses Using Multimodal Earbud Sensors.

Continuous stress exposure negatively impacts mental and physical well-being. Physiological arousal due to stress affects heartbeat frequency, changes breathing pattern and peripheral temperature, among several other bodily responses. Traditionally stress detection is performed by collecting signals such as electrocardiogram (ECG), respiration, and skin conductance response using uncomfortable sensors such as a chestband. In this study, we use earbuds that passively measure photoplethysmography (PPG), core body temperature, and inertial measurements. We have conducted a lab study exposing 18 participants to an evaluated speech task and additional tasks aimed at increasing stress or promoting relaxation. We simultaneously collected PPG, ECG, impedance cardiography (ICG), and blood pressure using laboratory grade equipment as reference measurements. We show that the earbud PPG sensor can reliably capture heart rate and heart rate variability. We further show that earbud signals can be used to classify the physiological responses associated with stress with 91.30% recall, 80.52% precision, and 85.12% F1-score using a random forest classifier with leave-one-subject-out cross-validation. The accuracy can further be improved through multi-modal sensing. These findings demonstrate the feasibility of using earbuds for passively monitoring users' physiological responses.

Wearable Sensing and Mining of the Informativeness of Older Adults’ Physiological, Behavioral, and Cognitive Responses to Detect Demanding Environmental Conditions

Due to the decline in functional capability, older adults are more likely to encounter excessively demanding environmental conditions (that result in stress and/or mobility limitation) than the average person. Current efforts to detect such environmental conditions are inefficient and are not person-centered. This study presents a more efficient and person-centered approach that involves using wearable sensors to collect continuous bodily responses (i.e., electroencephalography, photoplethysmography, electrodermal activity, and gait) and location data from older adults to detect demanding environmental conditions. Computationally, this study developed a Random Forest algorithm—considering the informativeness of the bodily response—and a hot spot analysis-based approach to identify environmental locations with high demand. The approach was tested on data collected from 10 older adults during an outdoor environmental walk. The findings demonstrate that the proposed approach can detect demanding environmental conditions that are likely to result in stress and/or limited mobility for older adults.

Visual Aggression: Images of Martyrdom in Late Medieval Germany

Visual Aggression: Images of Martyrdom in Late Medieval Germany

Similarities between explaining dizziness and explaining pain? Exploring common patient experiences, theoretical models, treatment approaches and potential therapeutic narratives for persistent dizziness or pain

ABSTRACT Pain and dizziness are common experiences throughout the lifespan. However, nearly a quarter of those with acute pain or dizziness experience persistence, which is associated with disability, social isolation, psychological distress, decreased independence, and poorer quality of life. Thus, persistent pain or dizziness impacts peoples’ lives in similarly negative ways. Conceptual models of pain and dizziness also have many similarities. Many of these models are more expansive than explaining mere symptoms; rather they describe pain or dizziness as holistic experiences that are influenced by biopsychosocial and contextual factors. These experiences also appear to be associated with multi-modal bodily responses related to evaluation of safety, threat detection and anticipation, as influenced by expectations, and predictions anticipation, not simply a reflection of tissue injury or pathology. Conceptual models also characterize the body as adaptable and therefore capable of recovery. These concepts may provide useful therapeutic narratives to facilitate understanding, dethreaten the experience, and provide hope for patients. In addition, therapeutic alliance, promoting an active movement-based approach, building self-efficacy, and condition-specific approaches can help optimize outcomes. In conclusion, there are significant overlaps in the patient experience, theoretical models and potential therapeutic narratives that guide care for people suffering with persistent pain or dizziness.

New insights on the correspondence between subjective affective experience and physiological responses from representational similarity analysis.

Classical views suggest that experienced affect is related to a specific bodily response, whereas recent perspectives challenge this view postulating that similar affective experiences rather evoke different physiological responses. To further advance this debate in the field, we used representational similarity analysis to investigate the correspondence between subjective affect (arousal and valence ratings) and physiological reactions (skin conductance response [SCR], startle blink response, heart rate, and corrugator activity) across various emotion induction contexts (picture viewing task, sound listening task, and imagery task). Significant similarities were exclusively observed between SCR and arousal in the picture viewing task. However, none of the other physiological measures showed a significant relation with valence and arousal ratings in any of the tasks. These findings are discussed within the framework of the Populations hypothesis, suggesting that physiological responses do not depend on the experienced affect but are directly associated with the context in which they are evoked.

Simulated satiation: A scale measure of satiation in reality-enhancing technologies

Satiation occurs when consumers no longer enjoy an experience, and it can be experienced physiologically as a bodily response, as well as in cognition and affect (Redden, 2015; Galak & Redden, 2018). Satiation prominently influences consumers’ behaviours, reducing consumption desires and increasing product/service replacement and disposal. This creates a critical challenge for marketers. Research pertaining to how satiation occurs and influences the customer journey and consumer decision making process within the context of virtual reality technology is embryonic and requires investigation. The purpose of this research is to examine the impact of satiation on consumer decision making on primarily virtual reality, but also augmented and mixed reality applications (VR, AR, and MR). Various factors in VR and AR platforms can influence consumers’ decisions and perceptions, such as latency-rendering issues that delay feedback, discrepancy, and simply knowing that the experience is just a simulation. Such factors cannot be experienced in real-life settings; therefore, this study will explore satiation via reality-enhancing technology perspective and aims to create a “simulated satiation” scale. I define simulated satiation as any attenuation in perceived benefits that occurs within or results from vicarious and simulated intermediary sources. To create a “simulated satiation” scale, this research will employ four phases: item generation and content validity, scale purification and confirming the scale structure, testing convergent and divergent validities of the scale, and designing a predictive validity study to show how the scale can aid research. Following this, in this presentation, I will illustrate how to create the “simulated satiation” scale and its potential impact on the marketing world.

Development of a Scale to Examine Responses to Bodily Sensations.

Individual differences in the perception of bodily sensations is known to be associated with affective symptomatology. However, the way people psychologically respond to everyday bodily sensations has not been examined in a systematic and balanced way. Thus, we developed the Bodily Sensations Response Scale (BSRS) to evaluate participants' self-reported cognitive, emotional, and behavioral responses to their bodily sensations. We investigated the scale's factor structure and its psychometric properties in two studies. In Study 1, 297 participants completed the 50-item BSRS and exploratory factor analysis (EFA) was performed on the responses. In Study 2 (N = 284), confirmatory factor analysis (CFA) was used to confirm the factor structure of the 32-item BSRS identified in Study 1. In Study 1, the EFA identified a 32-item three-factor solution as the best fit for the data. Factor 1 described a defeat response to bodily sensations, Factor 2 described an acceptance response, and Factor 3 described a sensitization response. In Study 2, the three-factor solution was shown not to be parsimonious. Rather, CFA identified that the 27-item BSRS had two interpretable factors (Defeat and Acceptance) that explained participants' psychological responses to bodily sensations. The Defeat subscale was moderately to strongly correlated with awareness of bodily sensations (i.e., Body Perception Questionnaire-Short Form scores) and depression, anxiety, and stress symptom severity (i.e., Depression Anxiety Stress Scales-21 scores), whereas the Acceptance subscale was unrelated or only slightly negatively correlated to awareness of bodily sensations and depression, anxiety, and stress symptoms. The 27-item BSRS provides a psychometrically robust assessment of the way in which people psychologically respond to everyday bodily sensations. The measure can assist researchers to better understand how people psychologically process their salient bodily sensations and how this is linked to psychopathology.

Механизмы эмоционального реагирования детей с задержкой психического развития

The article examines the characteristic mechanisms of the emotional response of children with mental retardation. The study of domestic authors on this issue is carried out within the framework of identifying the specifics of emotional manifestations and assessing the emotional response in children and adults. A comparison is made of the characteristics of perception, differentiation and understanding of various emotions, the manifestation of emotional reactions by children with disabilities and children with normal mental development. The study involved 260 children aged 9–10 years, including 130 children with mental retardation and 130 schoolchildren with normal mental development. Research methods are projective methods and conversation. Children with mental retardation carry out the identification of emotions using a more non-verbal channel, differentiate the bodily response to situations, experience difficulties in verbalizing their emotions and isolating cause-and-effect relationships between the situation and the emotion. Children with normal mental development perceive and differentiate emotions through verbal manifestations, highlight causal relationships between the situation and emotion, and verbalize their emotional manifestations.

The Phanerozoic aftermath of the Cambrian information revolution: sensory and cognitive complexity in marine faunas

AbstractThe Cambrian information revolution describes how biotically driven increases in signals, sensory abilities, behavioral interactions, and landscape spatial complexity drove a rapid increase in animal cognition concurrent with the Cambrian radiation. Here, we compare cognitive complexity in Cambrian and post-Cambrian marine ecosystems, documenting changes in animal cognition after the initial Cambrian increase. In a comparison of Cambrian and post-Cambrian Lagerstätten, we find no strong trend in the proportion of genera possessing two types of macroscopic sense organs (eyes and chemoreceptive organs such as antennae, feelers, or nostrils). There is also no trend in general nervous system complexity. These results suggest that sophisticated information processing was already common in early Phanerozoic ecosystems, comparable with behavioral evidence from the trace fossil record. Most taxa capable of complex information processing in Cambrian ecosystems were panarthropods, whereas mollusks and chordates made up larger proportions afterward. In both the Cambrian and the present day, ecological occupation of diverse habitat tiers and feeding modes is possible with even simple nervous systems, but ecological lifestyles requiring rapid, regular movement are almost exclusively associated within brain-bearing taxa, suggesting a connection with fast information-processing abilities and bodily responses. The overall rise in cognitive sophistication in the Cambrian was likely a unique event in the history of life, although some lineages subsequently developed more elaborate sensory systems and/or larger brains.

Identifying physiological correlates of cybersickness using heartbeat-evoked potential analysis

Many studies have consistently proven that repeatedly watching virtual reality (VR) content can reduce cybersickness. Moreover, the discomfort level decreases when the VR content includes an unusual orientation, such as an inverted scene. However, few studies have investigated the physiological changes during these experiences. The present study aimed to identify psychophysiological correlates, especially the neural processing, of cybersickness. Twenty participants experienced two types of VR orientation (upright and inverted), which were repeated three times. During the experience, we recorded the participants’ subjective levels of discomfort, brain waves, cardiac signals, and eye trajectories. We performed a heartbeat-evoked potential (HEP) analysis to elucidate the cortical activity of heartbeats while experiencing cybersickness. The results showed that the severity of cybersickness decreased as the participants repeatedly watched the VR content. The participants also reported less nausea when watching the inverted orientation. We only found a significant suppression at the fronto-central HEP amplitudes in the upright orientation for the physiological changes. This study provides a comprehensive understanding of bodily responses to varying degrees of cybersickness. In addition, the HEP results suggest that this approach might reflect the neural correlates of transient changes in heartbeats caused by cybersickness.

‘Use your white voice’: race, sound, and genre in Sorry to Bother You

ABSTRACT Looking primarily at Boots Riley’s Sorry to Bother You (2018), this essay explores the way race informs the relationship between the ‘body genres’ of comedy and horror. Riley’s film works through genre hybridity and ‘genre switching’, and this essay examines the links between the film’s genre reflexivity and the other kind of reflex – the ‘involuntary bodily response’. By locating its critique – by assaulting genre – at the level of sound, the film offers a way for us to think about our own involuntary responses, our own reflexes, when it comes to racial categories and racial identity. Looking particularly at the ‘white voice’ device, I argue that the film’s formal and stylistic strategies also enact a deeper critique, revisiting and re-activating the ways in which the basic conditions of the cinematic illusion have been suffused with racialized meaning in American film. In particular, the film’s strategies reflect how an imaginary Blackness has worked to generate genre and to animate the links between genres – especially comedy and horror. By reflecting on embodiment and disembodiment – and the synchronization of sound and image – Sorry to Bother You exploits genre, working it like a puppet, or like a monstrous filmic body.

Introduction

Introduction Eszter Zimanyi (bio) and Emma Ben Ayoun (bio) Since the mid-2010s, humanitarian organizations, journalists, and artists have increasingly been turning to virtual reality (VR) and immersive filmmaking for its ostensibly unprecedented ability to conjure empathic feelings that lead to humanitarian action.1 Technology companies and charitable institutions alike have touted immersive storytelling's "potential for good"; prominent examples include the United Nations High Commissioner for Refugees virtual reality program, UNICEF's Augmented Reality/Virtual Reality for Good initiative, and Oculus's VR for Good project.2 These initiatives emphasize the power of immersive media in a variety of instructive contexts, including medical training and diagnostics, physical and psychological therapy, interactive historical education modules, and philanthropic fundraising for humanitarian causes.3 Scholars including Kate Nash, Mandy Rose, and Sasha Crawford-Holland have attended to the possibilities and pitfalls of experiments in immersive media within the context of documentary filmmaking; however, these analyses [End Page 154] primarily focus on immersive media's visual components.4 In the context of VR filmmaking, scholars such as Adam Daniel, Sarah Jones, and Steve Dawkins have drawn attention to the spectator's ability to enact a sovereign gaze within 360-degree spherical images, leaving other bodily sensations un(der)accounted for.5 Although immersive nonfiction media depends in part on the believability of virtual environments, the fantasies at play in immersive media—which attempt to make viewers feel that they have participated in something real—are not only about creating convincing ocular illusions. They are also about generating persuasive haptic sensations and legible bodily responses from viewers. As such, the embodied experience of engaging with and navigating these environments demands sustained attention from media scholars studying immersive nonfiction. This is especially pertinent within the context of humanitarian media, which aims to inspire direct action from viewers and to foment wide-scale social change. What political and ethical concerns arise when rendering humanitarian crises not merely visible but also tangible for public consumption?6 In recent years, industry specialists, journalists, and early adopters of VR have heralded VR filmmaking as an unparalleled breakthrough in narrative storytelling, overshadowing an important element of its lineage: nonfiction media's long history of experimentation with interactivity and immersion.7 In the context of traditional cinema spectatorship, immersion has traditionally been defined as the loss of one's self to the narrative; however, Alison Griffiths defines immersion as "the sensation of entering a [End Page 155] space that immediately identifies itself as somehow separate from the world and that eschews conventional modes of spectatorship in favor of a more bodily participation in the experience."8 Following Griffiths's attention to bodily participation, we conceptualize nonfiction, humanitarian immersive media as media that makes a documentary claim to the real while seeking to directly mobilize spectators' bodies through the use of interactive and engrossing tactics.9 Throughout this introduction, we consciously engage the language used in promotional materials and interviews by the creators of many of these works—language that is often steeped in histories of exclusion and a very abstracted, and limited, understanding of VR's typical viewer. The fact that the majority of VR exhibition takes place in broadly inaccessible spaces—such as museums and festivals—means that the audiences who get to experience these works are imagined to be not only able-bodied but also correspondingly privileged in their modes of access to new technologies and artistic works. We define humanitarian media broadly to include projects engaged with both human and environmental concerns; likewise, our conception of nonfiction media includes contemporary digital projects that use personal testimonies and statistical data to ground their virtual representations of real-world characters and locations. Through this framework, our dossier re-centers and historicizes embodiment across maps, gallery installations, interactive web-based projects, and contemporary VR filmmaking in order to ask how immersive nonfiction media engage, discipline, destabilize, and erase the spectatorial body. What types of humanitarian responses can nonfiction media provoke when viewers are tasked with mastering (virtual) spaces through a mastery of their own bodies? The ethical implications of immersive nonfiction media, particularly virtual reality, have received a great deal of attention in recent years, both within media studies and beyond...

Review on Psychological Stress Detection Using Biosignals

This review investigates the effects of psychological stress on the human body measured through biosignals. When a potentially threatening stimulus is perceived, a cascade of physiological processes occurs mobilizing the body and nervous system to confront the imminent threat and ensure effective adaptation. Biosignals that can be measured reliably in relation to such stressors include physiological (EEG, ECG, EDA, EMG) and physical measures (respiratory rate, speech, skin temperature, pupil size, eye activity). A fundamental objective in this area of psychophysiological research is to establish reliable biosignal indices that reveal the underlying physiological mechanisms of the stress response. Motivated by the lack of comprehensive guidelines on the relationship between the multitude of biosignal features used in the literature and their corresponding behaviour during stress, in this paper, the impact of stress to multiple bodily responses is surveyed. Emphasis is put on the efficiency, robustness and consistency of biosignal data features across the current state of knowledge in stress detection. It is also explored multimodal biosignal analysis and modelling methods for deriving accurate stress correlates. This paper aims to provide a comprehensive review on biosignal patterns caused during stress conditions and reliable practical guidelines towards more efficient detection of stress.

A closer look at the time course of bodily responses to awe experiences

A closer look at the time course of bodily responses to awe experiences

Multi-Modal Regulation of Circadian Physiology by Interactive Features of Biological Clocks.

Simple SummaryCircadian rhythms, driven by molecular clockwork, exist in nearly all cells and tissues throughout the body, and these rhythmic oscillators constitute tightly coupled network systems that generate rhythmic physiology and behavior. Common circadian disrupting factors, such as night shift work and mistimed eating, can increase the risk of disease onset and symptoms. Disease can then, in turn, promote circadian disruption, leading to a vicious cycle of adverse circadian and overall health effects. This relationship suggests the importance of well-coordinated internal clock systems that maintain optimal synchrony with environmental and metabolic cues. In this review, we will recount the recent advances in circadian clock research and discuss how circadian clocks reciprocally interact with other signaling and metabolic factors to coordinate the daily rhythms of physiology.The circadian clock is a fundamental biological timing mechanism that generates nearly 24 h rhythms of physiology and behaviors, including sleep/wake cycles, hormone secretion, and metabolism. Evolutionarily, the endogenous clock is thought to confer living organisms, including humans, with survival benefits by adapting internal rhythms to the day and night cycles of the local environment. Mirroring the evolutionary fitness bestowed by the circadian clock, daily mismatches between the internal body clock and environmental cycles, such as irregular work (e.g., night shift work) and life schedules (e.g., jet lag, mistimed eating), have been recognized to increase the risk of cardiac, metabolic, and neurological diseases. Moreover, increasing numbers of studies with cellular and animal models have detected the presence of functional circadian oscillators at multiple levels, ranging from individual neurons and fibroblasts to brain and peripheral organs. These oscillators are tightly coupled to timely modulate cellular and bodily responses to physiological and metabolic cues. In this review, we will discuss the roles of central and peripheral clocks in physiology and diseases, highlighting the dynamic regulatory interactions between circadian timing systems and multiple metabolic factors.

Stress reduction via neuro-emotional technique to achieve the simultaneous resolution of chronic low back pain with multiple inflammatory and biobehavioural indicators: A randomized, double-blinded, placebo-controlled trial

BackgroundBeginning with the concepts of stress developed by Selye, an approach to stress and pain management, known as neuro-emotional technique (NET), has been developed. It is a treatment approach based on the principle that the stressor effects of dormant and/or current unresolved issues or trauma are what determine one’s bodily responses. These responses are relatively personalized to the conditioned, experiential and emotional reality of the individual. ObjectiveTo determine the effect of NET on patients with chronic low back pain (CLBP) over time. Design, setting, participants, and interventionsIn a randomized, double-blinded, placebo-controlled study conducted in a single clinic, NET or control treatments were given twice weekly for 4 weeks in a population of 112 patients. Main outcome measuresOutcome measures, including Oswestry Disability Index, Quadruple Visual Analogue Scale, the psychoneuroimmunology markers of blood serum levels of C-reactive protein, tumour necrosis factor-α, interleukin-1 (IL-1), IL-6, and IL-10, and 10 dimensions of the Short Form Health Survey scale, were assessed at baseline and at 1, 3 and 6 months following the intervention period. ResultsCompared to placebo, NET produced clinical and statistical significance (P < 0.001) via declines of virtually all physiological, pain and disability markers, accompanied by gains in quality-of-life indicators at 0 (baseline), 1, 3 and 6 months. Reductions of the percentages of patients whose 5 biomarkers lay outside the normative range were achieved at 1, 3 and 6 months by NET but not control interventions. ConclusionA randomized, controlled trial of CLBP patients indicated that 8 NET interventions, compared to placebo, produced clinically and statistically significant reductions in pain, disability and inflammatory biomarkers, and improvements in quality-of-life measures. Trial registrationThe trial was registered with the Australian and New Zealand Clinical Trials Registry (No. ACTRN12608000002381).