Neurophysiological Model Research Articles

Top-Down Priors Disambiguate Target and Distractor Features in Simulated Covert Visual Search.

Several models of visual search consider visual attention as part of a perceptual inference process, in which top-down priors disambiguate bottom-up sensory information. Many of these models have focused on gaze behavior, but there are relatively fewer models of covert spatial attention, in which attention is directed to a peripheral location in visual space without a shift in gaze direction. Here, we propose a biologically plausible model of covert attention during visual search that helps to bridge the gap between Bayesian modeling and neurophysiological modeling by using (1) top-down priors over target features that are acquired through Hebbian learning, and (2) spatial resampling of modeled cortical receptive fields to enhance local spatial resolution of image representations for downstream target classification. By training a simple generative model using a Hebbian update rule, top-down priors for target features naturally emerge without the need for hand-tuned or predetermined priors. Furthermore, the implementation of covert spatial attention in our model is based on a known neurobiological mechanism, providing a plausible process through which Bayesian priors could locally enhance the spatial resolution of image representations. We validate this model during simulated visual search for handwritten digits among nondigit distractors, demonstrating that top-down priors improve accuracy for estimation of target location and classification, relative to bottom-up signals alone. Our results support previous reports in the literature that demonstrated beneficial effects of top-down priors on visual search performance, while extending this literature to incorporate known neural mechanisms of covert spatial attention.

Anxiety and curiosity in hierarchical models of neural emotion processing-A mini review.

Traditionally, two fundamentally different theoretical approaches have been used in emotion research to model (human) emotions: discrete emotion theories and dimensional approaches. More recent neurophysiological models like the hierarchical emotion theory suggest that both should be integrated. The aim of this review is to provide neurocognitive evidence for this perspective with a particular focus on experimental studies manipulating anxiety and/or curiosity. We searched for evidence that the neuronal correlates of discrete and dimensional emotional systems are tightly connected. Our review suggests that the ACC (anterior cingulate cortex) responds to both, anxiety, and curiosity. While amygdala activation has been primarily observed for anxiety, at least the NAcc (nucleus accumbens) responds to both, anxiety and curiosity. When these two areas closely collaborate, as indicated by strong connectivity, this may indicate emotion regulation, particularly when the situation is not predictable.

Pathophysiology of cluster headache: From the trigeminovascular system to the cerebral networks.

Despite advances in neuroimaging and electrophysiology, cluster headache's pathogenesis remains unclear. This review will examine clinical neurophysiology studies, including electrophysiological and functional neuroimaging, to determine if they might help us construct a neurophysiological model of cluster headache. Clinical, biochemical, and electrophysiological research have implicated the trigeminal-parasympathetic system in cluster headache pain generation, although the order in which these two systems are activated, which may be somewhat independent, is unknown. Electrophysiology and neuroimaging have found one or more central factors that may cause seasonal and circadian attacks. The well-known posterior hypothalamus, with its primary circadian pacemaker suprachiasmatic nucleus, the brainstem monoaminergic systems, the midbrain, with an emphasis on the dopaminergic system, especially when cluster headache is chronic, and the descending pain control systems appear to be involved. Functional connection investigations have verified electrophysiological evidence of functional changes in distant brain regions connecting to wide cerebral networks other than pain. We propose that under the impact of external time, an inherited misalignment between the primary circadian pacemaker suprachiasmatic nucleus and other secondary extra- suprachiasmatic nucleus clocks may promote disturbance of the body's internal physiological clock, lowering the threshold for bout recurrence.

Fusion of Multi-Task Neurophysiological Data to Enhance the Detection of Attention- Deficit/Hyperactivity Disorder.

Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder with a prevalence ranging from 6.1 to 9.4%. The main symptoms of ADHD are inattention, hyperactivity, impulsivity, and even destructive behaviors that may have a long-term negative influence on learning performance or social relationships. Early diagnosis and treatment provide the best chance of reducing and managing symptoms. Currently, ADHD diagnosis relies on behavioral observations and ratings by clinicians and parents. Medical diagnosis of ADHD was reported to be delayed because of a global shortage of well-trained clinicians, the heterogeneous nature of ADHD, and combined comorbidities. Therefore, alternative ways to increase the efficiency of early diagnosis are needed. Previous studies used behavioral and neurophysiological data to assess patients with ADHD, yielding an accuracy range from 56.6% to 92%. Several factors were shown to affect the detection rate, including methods and tasks used and the number of electroencephalogram (EEG) channels. Given that children with ADHD have difficulty sustaining attention, in this study, we tested whether data from multiple tasks with different difficulties and prolonged experiment times can probe the levels of brain resources engaged during task performance and increase ADHD detection. Specifically, we proposed a Deep Neural Network-based (DNN) fusion model of multiple tasks to enhance the detection of ADHD. Forty-nine children with ADHD and thirty-two typically developing children were recruited. Analytic results show that the fusion of multi-task neurophysiological data can increase the separation rate to 89%, whereas a single data type can only achieve a best accuracy of 81%. Moreover, the use of multiple tasks helps distinguish between children with ADHD and typically developing children. Our results suggest that different neurophysiological models from multiple tasks can provide essential information to assist in ADHD screening. In conclusion, the proposed model offers a more efficient, and accurate alternative for early clinical diagnosis and management of ADHD. The application of artificial intelligence and multimodal neurophysiological data in clinical settings sets a precedent for digital health, paving the way for future advancements in the field.

Initial Response to Combination Therapies for Tinnitus: Lessons Learned From a Retrospective Analysis.

To investigate the initial reduction of tinnitus effects by combining common therapies applicable in general otology clinics and establishing optimal treatment strategies. Retrospective cohort study. A tertiary university hospital. Patients with nonpulsatile subjective tinnitus who visited the hospital between January and December 2022. Combination therapies consisting of at least one of the directive counseling based on the neurophysiological model, hearing aids, medication, and/or neuromodulation were performed. Tinnitus Handicap Inventory (THI) questionnaire at both their initial visit and 1-month follow-up. A total of 151 patients were enrolled. THI improvement of 20 points or more was observed in 31.8% of participants. One-way analysis of variance revealed that counseling had a significant reduction in THI, whereas neuromodulation, medication, and hearing aids did not. THI improvement was significantly associated with received counseling, severity of initial THI, and mean loudness discomfort level. Hearing aids and neuromodulation were not significant prognostic factors for improvement. Counseling alone is the best treatment for most patients with tinnitus. There will be other patients with tinnitus that, in addition to counseling, would benefit from hearing aids, medications, and/or certain forms of neuromodulation.

The Dysfunctional Mechanisms Throwing Tics: Structural and Functional Changes in Tourette Syndrome.

Tourette Syndrome (TS) is a high-incidence multifactorial neuropsychiatric disorder characterized by motor and vocal tics co-occurring with several diverse comorbidities, including obsessive-compulsive disorder and attention-deficit hyperactivity disorder. The origin of TS is multifactorial, with strong genetic, perinatal, and immunological influences. Although almost all neurotransmettitorial systems have been implicated in TS pathophysiology, a comprehensive neurophysiological model explaining the dynamics of expression and inhibition of tics is still lacking. The genesis and maintenance of motor and non-motor aspects of TS are thought to arise from functional and/or structural modifications of the basal ganglia and related circuitry. This complex wiring involves several cortical and subcortical structures whose concerted activity controls the selection of the most appropriate reflexive and habitual motor, cognitive and emotional actions. Importantly, striatal circuits exhibit bidirectional forms of synaptic plasticity that differ in many respects from hippocampal and neocortical plasticity, including sensitivity to metaplastic molecules such as dopamine. Here, we review the available evidence about structural and functional anomalies in neural circuits which have been found in TS patients. Finally, considering what is known in the field of striatal plasticity, we discuss the role of exuberant plasticity in TS, including the prospect of future pharmacological and neuromodulation avenues.

The neurophysiological Behavioral Perspective Model of consumer choice and its contribution to the intentional behaviorist research programme.

Cognitive explanations raise epistemological problems not faced by accounts confined to observable variables. Many explanatory components of cognitive models are unobservable: beliefs, attitudes, and intentions, for instance, must be made empirically available to the researcher in the form of measures of observable behavior from which the latent variables are inferred. The explanatory variables are abstract and theoretical and rely, if they are to enter investigations and explanations, on reasoned agreement on how they can be captured by proxy variables derived from what people say and how they behave. Psychometrics must be founded upon a firm, intersubjective agreement among researchers and users of research on the relationship of behavioral measures to the intentional constructs to which they point and the latent variables they seek to operationalize. Only if these considerations are adequately addressed can we arrive at consistent interpretations of the data. This problem provides the substance of the intentional behaviorist research programme which seeks to provide a rationale for the cognitive explanation. Within this programme, two versions of the Behavioral Perspective Model (BPM), an extensional portrayal of socioeconomic behavior and a corresponding intentional approach, address the task of identifying where intentional explanation becomes necessary and the form it should take. This study explores a third version, based on neurophysiological substrates of consumer choice as a contributor to this task. The nature of "value" is closely related to the rationale for a neurophysiological model of consumer choice. The variables involved are operationally specified and measured with high intersubjective agreement. The intentional model (BPM-I), depicting consumer action in terms of mental processes such as perception, deliberation, and choice, extends the purview of the BPM to new situations and areas of explanation.

Securing air transportation safety through identifying pilot's risky VFR flying behaviours: An EEG-based neurophysiological modelling using machine learning algorithms

Most general aviation accidents result from pilot errors while flying under visual flight rules (VFR), many of which are linked to situation awareness prone to meteorological and situational effects. This study reveals the impacts of weather and flight route factors contributing to unsafe flight behaviours on pilots’ performance (flight operation & neurophysiology). Importantly, another purpose is to identify risky flight behaviours by executing EEG-based neurophysiological modelling for securing air transportation safety. A two-by-two (adverse/clear weather; experienced/inexperienced flight route) within-subject experiment was conducted. Inexperienced flight routes have an explicit impact on contributing to unsafe flight operations except during departure and descent. However, the neurophysiological activity in power spectrum density and cooperative correlation showed that meteorology deterioration may require more mental efforts and have an implicit impact on maintaining safe flight awareness, making it challenging to correct risky flight operations due to mental resource exhaustion possibly. For the pilot's risky behaviour identification, neurophysiological modelling using EEG data was established, and a leave-one-subject-out cross-validation was used to evaluate the modelling feasibility, with the highest accuracy of 80.8%. This work could serve as the foundation for developing a real-time risky flight behaviour prediction modelling that could support safety-enhancing air transportation via artificial intelligence.

Behavioral Assessment of Zwicker Tone Percepts in Gerbils

The Zwicker tone illusion – an auditory phantom percept after hearing a notched noise stimulus – can serve as an interesting model for acute tinnitus. Recent mechanistic models suggest that the underlying neural mechanisms of both percepts are similar. To date it is not clear if animals do perceive the Zwicker tone, as up to now no behavioral paradigms are available to objectively assess the presence of this phantom percept.Here we introduce, for the first time, a modified version of the gap pre-pulse inhibition of the acoustic startle reflex (GPIAS) paradigm to test if it is possible to induce a Zwicker tone percept in our rodent model, the Mongolian gerbil. Furthermore, we developed a new aversive conditioning learning paradigm and compare the two approaches.We found a significant increase in the GPIAS effect when presenting a notched noise compared to white noise gap pre-pulse inhibition, which is consistent with the interpretation of a Zwicker tone percept in these animals. In the aversive conditioning learning paradigm, no clear effect could be observed in the discrimination performance of the tested animals. When investigating the first 33% of the correct conditioned responses, an effect of a possible Zwicker tone percept can be seen, i.e. animals show identical behavior as if a pure tone was presented, but the paradigm needs to be further improved. Nevertheless, the results indicate that Mongolian gerbils are able to perceive a Zwicker tone and can serve as a neurophysiological model for human tinnitus generation.

The neurophysiological approach to misophonia: Theory and treatment.

Clinical observations of hundreds of patients who exhibited decreased tolerance to sound showed that many of them could not be diagnosed as having hyperacusis when negative reactions to a sound depend only on its physical characteristics. In the majority of these patients, the physical characteristics of bothersome sounds were secondary, and patients were able to tolerate other sounds with levels higher than sounds bothersome for them. The dominant feature determining the presence and strength of negative reactions are specific to a given patient's patterns and meaning of bothersome sounds. Moreover, negative reactions frequently depend on the situation in which the offensive sound is presented or by whom it is produced. Importantly, physiological and emotional reactions to bothersome sounds are very similar (even identical) for both hyperacusis and misophonia, so reactions cannot be used to diagnose and differentiate them. To label this non-reported phenomenon, we coined the term misophonia in 2001. Incorporating clinical observations into the framework of knowledge of brain functions allowed us to propose a neurophysiological model for misophonia. The observation that the physical characterization of misophonic trigger was secondary and frequently irrelevant suggested that the auditory pathways are working in identical manner in people with as in without misophonia. Descriptions of negative reactions indicated that the limbic and sympathetic parts of the autonomic nervous systems are involved but without manifestations of general malfunction of these systems. Patients with misophonia could not control internal emotional reactions (even when fully realizing that these reactions are disproportionate to benign sounds evoking them) suggesting that subconscious, conditioned reflexes linking the auditory system with other systems in the brain are the core mechanisms of misophonia. Consequently, the strength of functional connections between various systems in the brain plays a dominant role in misophonia, and the functional properties of the individual systems may be perfectly within the norms. Based on the postulated model, we proposed a treatment for misophonia, focused on the extinction of conditioned reflexes linking the auditory system with other systems in the brain. Treatment consists of specific counseling and sound therapy. It has been used for over 20 years with a published success rate of 83%.

Human motor behaviour. An outline of a system-theoretical approach.

The author presents a system-theoretical approach (STA) to the issue of the construction and control of motor operations in humans. It is based on the theory of Nikolai Bernstein, who developed a neurophysiological model called the ‘brain skyscraper’, of a systemic nature. Taking it as a model, a functional equivalent of a skyscraper, a modalities’ ladder, was developed. The common denominator of both these mental structures is the system-theoretical basis for the construction and control of motor operations in humans. The science of human motor behaviour – anthropokinetics – eludes mathematical description and explanation, which works well in physics. STA, however, seems to be a promising method of revealing specific aspects of anthropokinetics. This is one of the possible perspectives that allows us to analyse such a multifaceted and complex problem as human motor behaviour, which is the only observable manifestation of any mental activity. This is probably the greatest intellectual challenge for all modern science. STA is an original method of thinking about human motor behaviour, which probably reveals its specific aspects and thus may contribute to a better understanding of anthropokinetics. It also enables the construction of an original, novel family tree of science as a whole.

Hierarchical psychophysiological pathways subtend perceptual asymmetries in Neglect

Stroke patients with left Hemispatial Neglect (LHN) show deficits in perceiving left contralesional stimuli with biased visuospatial perception towards the right hemifield. However, very little is known about the functional organization of the visuospatial perceptual neural network and how this can account for the profound reorganization of space representation in LHN.In the present work, we aimed at (1) identifying EEG measures that discriminate LHN patients against controls and (2) devise a causative neurophysiological model between the discriminative EEG measures. To these aims, EEG was recorded during exposure to lateralized visual stimuli which allowed for pre-and post-stimulus activity investigation across three groups: LHN patients, lesioned controls, and healthy individuals. Moreover, all participants performed a standard behavioral test assessing the perceptual asymmetry index in detecting lateralized stimuli. The between-groups discriminative EEG patterns were entered into a Structural Equation Model for the identification of causative hierarchical associations (i.e., pathways) between EEG measures and the perceptual asymmetry index.The model identified two pathways. A first pathway showed that the combined contribution of pre-stimulus frontoparietal connectivity and individual-alpha-frequency predicts post-stimulus processing, as measured by visual-evoked N100, which, in turn, predicts the perceptual asymmetry index. A second pathway directly links the inter-hemispheric distribution of alpha-amplitude with the perceptual asymmetry index. The two pathways can collectively explain 83.1% of the variance in the perceptual asymmetry index.Using causative modeling, the present study identified how psychophysiological correlates of visuospatial perception are organized and predict the degree of behavioral asymmetry in LHN patients and controls.

The Treatment Outcome of Smart Device-Based Tinnitus Retraining Therapy: Prospective Cohort Study.

Tinnitus retraining therapy (TRT) is a standard treatment for tinnitus that consists of directive counseling and sound therapy. However, it is based on face-to-face education and a time-consuming protocol. Smart device-based TRT (smart-TRT) seems to have many advantages, but the efficacy of this new treatment has been questioned. The aim of this study was to compare the efficacy between smart-TRT and conventional TRT (conv-TRT). We recruited 84 patients with tinnitus. Results were compared between 42 patients who received smart-TRT and 42 control participants who received conv-TRT. An interactive smart pad application was used for directive counseling in the smart-TRT group. The smart pad application included detailed education on ear anatomy, the neurophysiological model of tinnitus, concept of habituation, and sound therapy. The smart-TRT was bidirectional: There were 17 multiple choice questions between each lesson as an interim check. The conv-TRT group underwent traditional person-to-person counseling. The primary outcome measure was the Tinnitus Handicap Inventory (THI), and the secondary outcome measure was assessed using a visual analogue scale (VAS). Both treatments had a significant treatment effect, which comparably improved during the first 2 months. The best improvements in THI were -23.3 (95% CI -33.1 to -13.4) points at 3 months and -16.8 (95% CI -30.8 to -2.8) points at 2 months in the smart-TRT group and conv-TRT group, respectively. The improvements on the VAS were also comparable: smart-TRT group: -1.2 to -3.3; conv-TRT: -0.7 to -1.7. TRT based on smart devices can be an effective alternative for tinnitus patients. Considering the amount of time needed for person-to-person counseling, smart-TRT can be a cost-effective solution with similar treatment outcomes as conv-TRT.

Neurophysiological consequences of synapse loss in progressive supranuclear palsy.

Synaptic loss occurs early in many neurodegenerative diseases and contributes to cognitive impairment even in the absence of gross atrophy. Currently, for human disease there are few formal models to explain how cortical networks underlying cognition are affected by synaptic loss. We advocate that biophysical models of neurophysiology offer both a bridge from preclinical to clinical models of pathology and quantitative assays for experimental medicine. Such biophysical models can also disclose hidden neuronal dynamics generating neurophysiological observations such as EEG and magnetoencephalography. Here, we augment a biophysically informed mesoscale model of human cortical function by inclusion of synaptic density estimates as captured by 11C-UCB-J PET, and provide insights into how regional synapse loss affects neurophysiology. We use the primary tauopathy of progressive supranuclear palsy (Richardson's syndrome) as an exemplar condition, with high clinicopathological correlations. Progressive supranuclear palsy causes a marked change in cortical neurophysiology in the presence of mild cortical atrophy and is associated with a decline in cognitive functions associated with the frontal lobe. Using parametric empirical Bayesian inversion of a conductance-based canonical microcircuit model of magnetoencephalography data, we show that the inclusion of regional synaptic density-as a subject-specific prior on laminar-specific neuronal populations-markedly increases model evidence. Specifically, model comparison suggests that a reduction in synaptic density in inferior frontal cortex affects superficial and granular layer glutamatergic excitation. This predicted individual differences in behaviour, demonstrating the link between synaptic loss, neurophysiology and cognitive deficits. The method we demonstrate is not restricted to progressive supranuclear palsy or the effects of synaptic loss: such pathology-enriched dynamic causal models can be used to assess the mechanisms of other neurological disorders, with diverse non-invasive measures of pathology, and is suitable to test the effects of experimental pharmacology.

Disrupted neural tracking of sound localization during non-rapid eye movement sleep

Spatial hearing in humans is a high-level auditory process that is crucial to rapid sound localization in the environment. Both neurophysiological models with animals and neuroimaging evidence from human subjects in the wakefulness stage suggest that the localization of auditory objects is mainly located in the posterior auditory cortex. However, whether this cognitive process is preserved during sleep remains unclear. To fill this research gap, we investigated the sleeping brain's capacity to identify sound locations by recording simultaneous electroencephalographic (EEG) and magnetoencephalographic (MEG) signals during wakefulness and non-rapid eye movement (NREM) sleep in human subjects. Using the frequency-tagging paradigm, the subjects were presented with a basic syllable sequence at 5 Hz and a location change that occurred every three syllables, resulting in a sound localization shift at 1.67 Hz. The EEG and MEG signals were used for sleep scoring and neural tracking analyses, respectively. Neural tracking responses at 5 Hz reflecting basic auditory processing were observed during both wakefulness and NREM sleep, although the responses during sleep were weaker than those during wakefulness. Cortical responses at 1.67 Hz, which correspond to the sound location change, were observed during wakefulness regardless of attention to the stimuli but vanished during NREM sleep. These results for the first time indicate that sleep preserves basic auditory processing but disrupts the higher-order brain function of sound localization.

Multimodal Neurophysiological Transformer for Emotion Recognition.

Understanding neural function often requires multiple modalities of data, including electrophysiogical data, imaging techniques, and demographic surveys. In this paper, we introduce a novel neurophysiological model to tackle major challenges in modeling multimodal data. First, we avoid non-alignment issues between raw signals and extracted, frequency-domain features by addressing the issue of variable sampling rates. Second, we encode modalities through "cross-attention" with other modalities. Lastly, we utilize properties of our parent transformer architecture to model long-range dependencies between segments across modalities and assess intermediary weights to better understand how source signals affect prediction. We apply our Multimodal Neurophysiological Transformer (MNT) to predict valence and arousal in an existing open-source dataset. Experiments on non-aligned multimodal time-series show that our model performs similarly and, in some cases, outperforms existing methods in classification tasks. In addition, qualitative analysis suggests that MNT is able to model neural influences on autonomic activity in predicting arousal. Our architecture has the potential to be fine-tuned to a variety of downstream tasks, including for BCI systems.

THE MECHANISM OF URINARY CONTROL AND OPERATIONS OF SYNTHETIC SLING

Background: Over the past two decades, synthetic loop surgeries have gained widespread popularity due to their ease of implementation, relatively high efficiency and low cost in the treatment of women with stress urinary incontinence (SUI). To date, several dozen variants of minimally invasive surgical procedures are known, but none of the known methods provides a 100% reliable result. At the same time, the effectiveness of the performed operation to eliminate involuntary loss of urine is inexorably reduced in the follow-up.Aims of the study. On the basis of a neuroregulatory theory published in 2019 and according to a neurophysiological model, provide an explanation for both the mechanism of urinary retention and the role of the tape implanted under the urethra in its recovery.Material and methods. Analysis of a large number of foreign and domestic literary sources, the results of clinical observations of surgery using the original author's version of the trocar synthetic sling (TSS) for 19 years, the data of the original method of uroflowmetric monitoring.Results. Taking into account the created and published theoretical basis, an explanation is presented for the effect of increasing the tone of the pelvic floor muscles in women with urinary incontinence after surgical correction using modern synthetic materials.Conclusions. The restoration of the mechanism of urinary retention in women after the operation of a synthetic sling occurs under the condition of activation of the 4th mictional reflex. In the event of a violation of the components of this reflex, the effectiveness of the sling procedure decreases and a recurrent form of the disease occurs, regardless of the type and volume of the operation used. The presence of a theoretical basis that explains both the mechanism of urinary retention itself and the pathogenesis of the development of the disease allows us to offer options for conservative therapy to prepare for the sling procedure and thereby increase the follow-up efficiency of any loop surgery.

Loop surgery in women with urinary incontinence and urodynamics of the lower urinary tract

Objective: The aim of the study is to objectify and evaluate urodynamic changes in women having urinary incontinence before and after performing synthetic sling operations.Methods: During the period from 2002 to 2020 104 women were observed (average age 54 years) who underwent trocar synthetic sling surgery. The group under observation included patients with a combined form of incontinence. The main method of urodynamic diagnosis was non-invasive 2-day uroflowmonitoring.Results: When comparing the data before and after TSS operation the following changes were found: an increase in the minimum capacity and a decrease in the maximum released volume, but together with this, the change in the average effective volume was unreliable. At the same time the structure of urination has radically changed. The indicators of the average value of the maximum flow have decreased and the entire speed profile has changed in general.Conclusions: Uroflowmetric monitoring makes it possible to identify objectively, adequately and non-invasively the urodynamic disorders in patients with urinary incontinence, which occur both in the preoperative and postoperative periods. According to the neurophysiological model these changes can be explained by the influence of the implant on micturition reflexes.

Review of Obsessive Compulsive Disorders Theories

The present review aimed to analyze the scientific literature untill 2010 about the theories of Obsessive Compulsive Disorder in order to make clear how a biological and cognitive hypotheses might be integrated in a comprehensive point of view.
 In the analysis, at biological level were included neuroanatomic and neurophysiologic models and animal models; instead at cognitive level were included different theories of Salwoskies, Van den Hout, Mancini e Rachman. Biological, cognitive, and behavioral elements of the theories have to be clearly distinguished between specific and general conditions, as do critical past events and current trigger conditions. The theories compared were drawn from the neurobiological, cognitive, and behavioral literature that proposed empirical supported models. We conclude that there are substantive differences among the cognitive theories and between the biological theories reviewed. However, cognitive and biological theories appear to be compatible in principle. It is not clear whether substantive differences among theories are due to the existence of subtypes of OCD or due to the predominance of multifactorial cause.
 It is argued that current treatment methods imply particular theories, and that particular patterns of success and failure can be understood in relation to theory through the methods we have employed.

Influência da religião e da espiritualidade islâmica no bem-estar e na qualidade de vida de pacientes com câncer: uma metanálise e um modelo hipotético de mecanismos cerebrais

ABSTRACT Objective: To systematically analyze quantitative data about the effects of religion/spirituality and the well-being/quality of life of cancer patients. The second aim was to hypothesize a neurophysiological model of the association between religion/spirituality and the brain. Methods: This study met the PRISMA Statement and was registered at PROSPERO database. Randomized and Controlled trials investigating religion/spirituality and well-being/quality of life of cancer patients were included. Based on neuroimaging and neurophysiology studies, a neuroanatomical model was developed to hypothesize the relationship between neuroscience and religion/spirituality. Results: A large effect size was found on the improvement of well-being/quality of life (SMD = 3.90 [2.43-5.38], p < 0.01). Heterogeneity was high among studies (I2 = 98%, p < 0.01). Specific regions of the brain, such as the temporal lobes, amygdalae and hippocampus, regions from the limbic system, were hypothesized to take part in the religion/spirituality phenomena and the well-being/quality of life improvement. Conclusion: Religion/spirituality intervention, mainly the Islamic, promotes an improvement on well-being/quality of life of cancer patients.