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Social Behavior:
        An Emergent property of the
    phylogeny of the autonomic nervous
                  system

               Stephen W. Porges, Ph.D.
                   Brain-Body Center
             University of Illinois at Chicago
                   sporges@uic.edu




                Acknowledgments
    ! Special thanks to:
           Olga Bazhenova, Ph.D.
       »
       »   John Denver
       »   Keri Heilman
       »   Jane Sorokin
       »   Elgiz Bal
    ! Funding provided by:
       »   NIMH Grant MH-60625
       »   NLMF Family Foundation
       »   Unicorn Children’s Foundation
       »   Cure Autism Now




    Overview: The Polyvagal Theory
•   Evolution provides an organizing principle to understand
    neural regulation of the human autonomic nervous
    system.
•   Three neural circuits form a phylogenetically-ordered
    response hierarchy that regulate behavioral and
    physiological adaptation to safe, dangerous, and life
    threatening environments.
•   “Neuroception” of danger or safety or life threat trigger
    these adaptive neural circuits.
•   New models relating neural regulation to health, learning,
    and social behavior may be reversed- engineered into
    treatments.
The metaphor of safety: A basic principle
           of our nervous system

                                       Environment
                                       outside the body
                                        inside the body



                                    Nervous System
                                          Neuroception


                      Safety                  Danger                     Life threat
Spontaneously engages others
                                                            Defensive strategies
eye contact, facial expression, prosody
                                                            death feigning/shutdown (immobilization)
supports visceral homeostasis

                           Defensive strategies
                             fight/flight behaviors (mobilization)




                                    Evolution
      Neural Regulation of the Heart in Vertebrates
                     CHM DMX SNS AD/m NA
                                      X+
   Cyclostomes
   Elasmobranchs                      X+            X-

                                      X+            X-           X+
   Teleosts
                                      X+            X-           X+
   Amphibians
                                      X+            X-           X+          X+
   Reptiles
                                      X+            X-           X+          X+           X-
   Mammals




                     Polyvagal Theory:
 Emergent “Emotion” Subsystems
                                                      VVC        SNS        DVC
                   heart rate                         +/-         +           -
                   bronchi                            +/-            +        -
                   gastrointestinal                                  -        +
                   vasoconstriction                                  +
                   sweat                                             +
                   adrenal medulla                                   +
                   tears                              +/-
                   vocalization                       +/-
                   facial muscles                     +/-
                   eyelids                            +/-
                   middle ear muscles                 +/-
Polyvagal Theory: Phylogenetic
          Stages of Neural Control
Stage ANS Component Behavioral Function                           Lower motor
                                                                  neurons
             Myelinated vagus Social communication,               Nucleus ambiguus
III
                              self-soothing and
             (VVC – ventral vagal
             complex)         calming, inhibit
                              sympathetic-adrenal
                              influences
             Sympathetic-           Mobilization (active          Spinal cord
II
             adrenal system         avoidance)
             (SNS – sympathetic
             nervous system)
             Unmeyelinated          Immobilization (death         Dorsal motor
I
             vagus                  feigning, passive             nucleus of the
                                    avoidance)                    vagus
             (DVC – dorsal vagal
             complex)




      Polyvagal Theory: A Phylogenetic
      Hierarchy of Response Strategies


      Structure Function                                   VVC SNS DMX

      Head                  Communication                  +
      Limbs                                                          +
                            Mobilization
                                                                             +
      Viscera               Immobilization




       Phylogenetic Organization of
      the ANS: The Polyvagal Theory

                                                            head




                                                               viscera
     limbs

                                                                 trunk
Phylogenetic Organization of
 the ANS: The Polyvagal Theory

                     head
                            “old” vagus



                      viscera
limbs

                        trunk




        Vasovagal Syncope




        Apnea/Bradycardia
Phylogenetic Organization of
  the ANS: The Polyvagal Theory

                          head




                          viscera
limbs

                             trunk




   Phylogenetic Organization of
  the ANS: The Polyvagal Theory
 Corticospinal Pathways
                          head
Sympathetic Nervous
     System



                          viscera
limbs

                             trunk




Mobilization: Flight Behaviors
Mobilization: Fight Behaviors




            Mobilization:
        Fight/Flight Behaviors




  Phylogenetic Organization of
 the ANS: The Polyvagal Theory

                        head




                         viscera
limbs

                           trunk
Phylogenetic Organization of
    the ANS: The Polyvagal Theory

                                                          head
Corticobulbar pathways
                                                                           “new” vagus



                                                             viscera
  limbs

                                                                     trunk




                   Social Engagement




                                           © Jeff Hunter/ The Image Bank




        The “Smart” Vagus and
       Social Engagement System

                                 cortex


                             brainstem

     Muscles of                                                            Head Turning
                             Cranial Nerves
     Mastication
                              V,VII,IX,X,XI
      Middle Ear                                                             Bronchi
       Muscles

               Facial   Larynx            Pharynx                    Heart
              Muscles




                          environment
Social Engagement System:
           Emergent Behaviors at Birth




Social Engagement System:
                      Self Regulation




            Heart Rate Rhythms:
            A measure of the “new” vagus


                                                   RESP




            800
                       RSA
 HP (ms)




                                  0.10
            900

                                                            60 BPM
           1000

                       HPV
           1100


           1200
                  0          30          60   90          120
                                    SECONDS
Looking and Listening: Common
Neurophysiological Mechanisms




    Middle Ear Muscles:
  Role in Extracting Human Voice




                    Borg & Counter, 1989
                          t
                    Scientific American




    Social Engagement
Social Engagement and Otis Media?




The Face: A Critical Component
of a Social Engagement System
• At birth the mammalian nervous system needs a
“caregiver” to survive and signals the caregiver via
the muscles of the face and head.
• At term the corticobulbar pathways that regulate the
striated muscles of the face are myelinated.
• The face is “hardwired” to the neural regulation of
visceral state via a mammalian “neural circuit.”
• Metabolic demands, stress, trauma and illness
retract the “mammalian” neural circuit with the
resultant symptoms of a face that does not work and
social engagement behaviors are absent.




      The Social Human Infant

                                                   Fantz, 1963
The Social Human Infant


Neonates can discriminate between direct
and averted eye gaze and look longer and
more frequently at faces with direct eye
gaze

 Farroni, Csibra, Simion, & Johnson (2002). Eye
 contact detection n humans from birth. Proceedings
 of the National Academy of Sciences, 99, 9602-
 9605.




My Child’s Face Does Not Work!




                                      Gabriel Metzu, The Sick Child




When Other Faces Do Not Work!
When the nervous system fails use Botox!




             Beauty is a journey that starts with a

             choice… Learn about your
             Choices




    Autism




      People Need People:
 A Biological Basis for Social Behavior
    Regulators of physiology are
    “embedded” in relationships
         M. Hofer
         New York State Psychiatric Institute
How are the adaptive defensive
systems (flight, fight, and freeze),
which are mediated by the amygdala
and other limbic structures, inhibited
to promote the positive spontaneous
social behavior associated with the
Social Engagement System?




                                            Neuroception
                                                  Life Threat




                                               Amygdala
                                                (central nucleus)


                                                  ventrolateral
                                    Periaqueductal Gray


                             Freeze                                   Autonomic State
                          (pyramidal tracks)                           (dorsal vagal regulation)




Inhibitory pathways
Excitatory pathways




                                           Neuroception
                                                  Danger




                                             Amygdala
                                              (central nucleus)



                                           dorsolateral and lateral
                                  Periaqueductal Gray
                                   Rostral                        Caudal




                          Fight                                            Flight
                      (pyramidal tracks)                              (pyramidal tracks)


                                      Autonomic State
                                                (sympathetic)
Inhibitory pathways
Excitatory pathways
The Trustworthiness of Faces




                                                                               R. Adolphs, 2002




                                            Neuroception
                                                Safe



                       FFA/STS                           Motor Cortex


                       Amygdala                               Medulla
                        (central nucleus)              (source nuclei V,VII,IX,X,XI)




                              Social Engagement System


               Somatomotor                                    Visceromotor
              (muscles of face & head)                            (heart, bronchi)


Inhibitory pathways
Excitatory pathways




      Social Engagement System:
Observable Deficits in Several Psychiatric and
           Behavioral Disorders

 • Prosody
 • Gaze
 • Facial expressivity
 • Mood and affect
 • Posture during social engagement
The Polyvagal Theory:
    Insights into the selection of outcome measures




                Stephen W. Porges, Ph.D.
                    Brain-Body Center
              University of Illinois at Chicago
                    sporges@uic.edu




                 Acknowledgments
      Special thanks to:
        •   Olga Bazhenova, Ph.D.
        •   John Denver, Ph.D.
        •   Keri Heilman, M.A.
        •   Jane Sorokin, M.A.
        •   Elgiz Bal
      Funding provided by:
        •   NIMH Grant MH-60625
        •   NLMF Family Foundation
        •   Unicorn Children’s Foundation
        •   Cure Autism Now




     Overview: The Polyvagal Theory
•    Evolution provides an organizing principle to understand
     neural regulation of the human autonomic nervous
     system.
•    Three neural circuits form a phylogenetically-ordered
     response hierarchy that regulate behavioral and
     physiological adaptation to safe, dangerous, and life
     threatening environments.
•    “Neuroception” of danger or safety or life threat trigger
     these adaptive neural circuits.
•    New models relating neural regulation to health, learning,
     and social behavior may be reversed- engineered into
     treatments.
Polyvagal Theory:
                               Risk Assessment

                                       Environment
                                       outside the body
                                        inside the body



                                    Nervous System
                                          Neuroception


                      Safety                  Danger                 Life threat
Spontaneously engages others
                                                            Defensive strategies
eye contact, facial expression, prosody
                                                            death feigning/shutdown (immobilization)
supports visceral homeostasis

                           Defensive strategies
                             fight/flight behaviors (mobilization)




            Social Engagement System
      Observable Deficits in Several Psychiatric and
                 Behavioral Disorders

    • Prosody
    • Gaze
    • Facial expressivity
    • Mood and affect
    • Posture during social engagement




                                               FXS
       A compromised social engagement system?




                                                                          http://www.fragilex.org
Behavioral Features of FXS
•    Hyperarousal, distractible, impulsive
•    Hypoarousal
•    Difficulties in listening
•    Sensory defensiveness
     • sound sensitivities
     • oral motor defensiveness
     • Tactile defensiveness/hypersensitivity
•    Poor eye contact and difficulties in social communication
•    Speech-language delays (males)
•    Anxiety
     • Hypervigilance
     • Affect regulation (e.g., tantrums)
     • Shyness
•    Low cardiac vagal tone
                                                     http://www.fragilex.org




     Phylogenetic Organization of
    the ANS: The Polyvagal Theory

                                                head
                                                          “old” vagus



                                                  viscera
limbs

                                                     trunk




              Vasovagal Syncope
Phylogenetic Organization of
  the ANS: The Polyvagal Theory
 Corticospinal Pathways
                          head
Sympathetic Nervous
     System



                          viscera
limbs

                             trunk




Mobilization: Flight Behaviors




   Mobilization: Fight Behaviors
Phylogenetic Organization of
    the ANS: The Polyvagal Theory

                                              head
Corticobulbar pathways
                                                               “new” vagus



                                                 viscera
  limbs

                                                         trunk




            Social Engagement




                               © Jeff Hunter/ The Image Bank




   Polyvagal Theory: A Phylogenetic
   Hierarchy of Response Strategies


    Structure Function                    VVC SNS DMX

    Head        Communication                +
    Limbs                                                      +
                Mobilization
                                                                   +
    Viscera     Immobilization
Social Engagement System
 Observable Deficits in Several Psychiatric and
            Behavioral Disorders

• Prosody
• Gaze
• Facial expressivity
• Mood and affect
• Posture during social engagement




    Social Engagement System
                              Anatomical basis

                                            cortex


                                      brainstem

  Muscles of                                                           Head Turning
                                          Cranial Nerves
  Mastication
                                           V,VII,IX,X,XI
   Middle Ear                                                               Bronchi
    Muscles

                 Facial         Larynx               Pharynx        Heart
                Muscles




                                  environment




                  Heart Rate Rhythms:
An autonomic component of social engagement


                                                                    RESP




                  800
                               RSA
      HP (ms)




                                             0.10
                  900

                                                                                 60 BPM
                 1000

                               HPV
                 1100


                 1200
                          0          30             60         90             120
                                                SECONDS
My Child’s Face Does Not Work!




                               Gabriel Metzu, The Sick Child




       Looking and Listening
Common Neurophysiological Mechanisms




      Middle Ear Muscles:
    Role in Extracting Human Voice




                      Borg & Counter, 1989
                            t
                      Scientific American
How are the adaptive defensive
systems (flight, fight, and freeze),
which are mediated by the amygdala
and other limbic structures, inhibited
to promote the positive spontaneous
social behavior associated with the
Social Engagement System?




                                            Neuroception
                                                  Life Threat




                                               Amygdala
                                                (central nucleus)


                                                  ventrolateral
                                    Periaqueductal Gray


                             Freeze                                   Autonomic State
                          (pyramidal tracks)                           (dorsal vagal regulation)




Inhibitory pathways
Excitatory pathways




                                           Neuroception
                                                  Danger




                                             Amygdala
                                              (central nucleus)



                                           dorsolateral and lateral
                                  Periaqueductal Gray
                                   Rostral                        Caudal




                          Fight                                            Flight
                      (pyramidal tracks)                              (pyramidal tracks)


                                      Autonomic State
                                                (sympathetic)
Inhibitory pathways
Excitatory pathways
The Trustworthiness of Faces




                                                                               R. Adolphs, 2002




                                            Neuroception
                                                Safe



                       FFA/STS                           Motor Cortex


                       Amygdala                               Medulla
                        (central nucleus)              (source nuclei V,VII,IX,X,XI)




                              Social Engagement System


               Somatomotor                                    Visceromotor
              (muscles of face & head)                            (heart, bronchi)


Inhibitory pathways
Excitatory pathways




      Social Engagement System:
Observable Deficits in Several Psychiatric and
           Behavioral Disorders

 • Prosody
 • Gaze
 • Facial expressivity
 • Mood and affect
 • Posture during social engagement
Social Engagement System
      Where to look? What to measure?
  Cortex                              ERP, EEG, EOP, fMRI

  Autonomic                           heart rate, vagal tone
                                      (RSA), respiration
  Middle ear muscles                  impedance
                                      words from noise
  Facial muscles                      facial EMG, thermography,
                                      video coding of faces
  Laryngeal/pharyngeal                acoustic properties of
  muscles                             vocalizations, language
  Gaze                                eye tracking




               Control: 12 year old male



Eye 57%




                                    106C
                         OFF %      EYE %   MOUTH %
                             32.6     57.18    10.22
Before Intervention: Autism 10 year old male



Eye 1%




                               111A
                    OFF %      EYE %    MOUTH %
                       39.31       1.15    59.54




    After Intervention: Autism 10 year old male



Eye 71%




                               119B
                    OFF %      EYE %   MOUTH %
                       26.15     71.38     2.47




          Fixation Duration Percent
    90
    80
    70
    60
    50                                                       Pre
    40                                                       Post
    30
    20
    10
     0



                                                   t(19) = -7.343, p <.0001
Fixation Duration Percent

 70
 60
 50
                                                      Control
 40
                                                      Pre
 30
                                                      Post
 20
 10
     0
           OFF          EYE          MOUTH

                 Control/Pre F(1,38) = 39.005***, 69.207***, .219 ns
                 Control/Post F(1,38) = 21.371***, 14.551***, .030 ns




                    SCAN Test
12

10

8
                                                        Control
6                                                       Pre
                                                        Post
4

2

0
          SCAN FW                SCAN CW

                      Control/Pre F(1,39) = 187.272***, 27.400***
                      Control/Post F(1,39) = 6.290**, 0.108 ns




         Respiratory Sinus Arrhythmia
                        (ln msec2)
     8

                     * Control * Pre * Post
     7


     6


     5


     4


     3
                                  Control/Pre F(1,38) = 16.067***
                                  Control/Post F(1,38) = 3.805 ns
                                  Pre/Post F(1,38) = 16.427***
What Needs to be Done?
 •New Populations: Apply the Listing Project interventions to
 individuals with language delays and older and more severe
 autistic individuals
 •Repeated interventions: Change protocol to evaluate the
 effect of repeated interventions on the trajectory of individuals
 in existing treatment programs.
 •Describe the autistic nervous system: Validate neural
 mechanisms mediating vulnerabilities in social engagement
 and the behavioral changes following intervention (fMRI, NIRS,
 ANS, facial EMG & IR thermography)
 •Expand intervention strategies: Incorporate visual stimuli to
 trigger multisensory neurons that facilitate language and social
 communication.




Potential Applications of the Polyvagal Theory
  in Psychiatry, Psychology, and Education
! Aspects of several physical and psychiatric diseases can be
  explained as emergent properties of the neural regulation of the
  autonomic nervous system (feedback, evolution, development)
! New diagnostic methods and new treatments can emphasize
  measurement and manipulation of the neural regulation of the
  autonomic nervous system.
! Environments can be designed to support the functions of the
  nervous system with positive impact on social behavior and
  emotion regulation
      – Computers that modulate neural regulation of the ANS
      – Quiet environments
      – Nervous system “friendly” classrooms
      – Improved social behavior: People need people – a biological basis




                         Summary
 •   “Neuroception” of safety or danger mediates the
     beneficial consequences of social behavior.
 •   Autonomic reactions to challenges are organized in a
     phylogenetically-determined hierarchy.
 •   Various atypical behaviors are adaptive for short
     periods.
 •   Several psychopathologies are expressed as deficits
     in the Social Engagement System.
 •   Biologically-based behavioral interventions can
     trigger neural circuits that mediate positive social
     behavior.

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Porges - Polyvagal - Autism - Hakomi Conference Presentation - Brain Behavior handout

  • 1. Social Behavior: An Emergent property of the phylogeny of the autonomic nervous system Stephen W. Porges, Ph.D. Brain-Body Center University of Illinois at Chicago sporges@uic.edu Acknowledgments ! Special thanks to: Olga Bazhenova, Ph.D. » » John Denver » Keri Heilman » Jane Sorokin » Elgiz Bal ! Funding provided by: » NIMH Grant MH-60625 » NLMF Family Foundation » Unicorn Children’s Foundation » Cure Autism Now Overview: The Polyvagal Theory • Evolution provides an organizing principle to understand neural regulation of the human autonomic nervous system. • Three neural circuits form a phylogenetically-ordered response hierarchy that regulate behavioral and physiological adaptation to safe, dangerous, and life threatening environments. • “Neuroception” of danger or safety or life threat trigger these adaptive neural circuits. • New models relating neural regulation to health, learning, and social behavior may be reversed- engineered into treatments.
  • 2. The metaphor of safety: A basic principle of our nervous system Environment outside the body inside the body Nervous System Neuroception Safety Danger Life threat Spontaneously engages others Defensive strategies eye contact, facial expression, prosody death feigning/shutdown (immobilization) supports visceral homeostasis Defensive strategies fight/flight behaviors (mobilization) Evolution Neural Regulation of the Heart in Vertebrates CHM DMX SNS AD/m NA X+ Cyclostomes Elasmobranchs X+ X- X+ X- X+ Teleosts X+ X- X+ Amphibians X+ X- X+ X+ Reptiles X+ X- X+ X+ X- Mammals Polyvagal Theory: Emergent “Emotion” Subsystems VVC SNS DVC heart rate +/- + - bronchi +/- + - gastrointestinal - + vasoconstriction + sweat + adrenal medulla + tears +/- vocalization +/- facial muscles +/- eyelids +/- middle ear muscles +/-
  • 3. Polyvagal Theory: Phylogenetic Stages of Neural Control Stage ANS Component Behavioral Function Lower motor neurons Myelinated vagus Social communication, Nucleus ambiguus III self-soothing and (VVC – ventral vagal complex) calming, inhibit sympathetic-adrenal influences Sympathetic- Mobilization (active Spinal cord II adrenal system avoidance) (SNS – sympathetic nervous system) Unmeyelinated Immobilization (death Dorsal motor I vagus feigning, passive nucleus of the avoidance) vagus (DVC – dorsal vagal complex) Polyvagal Theory: A Phylogenetic Hierarchy of Response Strategies Structure Function VVC SNS DMX Head Communication + Limbs + Mobilization + Viscera Immobilization Phylogenetic Organization of the ANS: The Polyvagal Theory head viscera limbs trunk
  • 4. Phylogenetic Organization of the ANS: The Polyvagal Theory head “old” vagus viscera limbs trunk Vasovagal Syncope Apnea/Bradycardia
  • 5. Phylogenetic Organization of the ANS: The Polyvagal Theory head viscera limbs trunk Phylogenetic Organization of the ANS: The Polyvagal Theory Corticospinal Pathways head Sympathetic Nervous System viscera limbs trunk Mobilization: Flight Behaviors
  • 6. Mobilization: Fight Behaviors Mobilization: Fight/Flight Behaviors Phylogenetic Organization of the ANS: The Polyvagal Theory head viscera limbs trunk
  • 7. Phylogenetic Organization of the ANS: The Polyvagal Theory head Corticobulbar pathways “new” vagus viscera limbs trunk Social Engagement © Jeff Hunter/ The Image Bank The “Smart” Vagus and Social Engagement System cortex brainstem Muscles of Head Turning Cranial Nerves Mastication V,VII,IX,X,XI Middle Ear Bronchi Muscles Facial Larynx Pharynx Heart Muscles environment
  • 8. Social Engagement System: Emergent Behaviors at Birth Social Engagement System: Self Regulation Heart Rate Rhythms: A measure of the “new” vagus RESP 800 RSA HP (ms) 0.10 900 60 BPM 1000 HPV 1100 1200 0 30 60 90 120 SECONDS
  • 9. Looking and Listening: Common Neurophysiological Mechanisms Middle Ear Muscles: Role in Extracting Human Voice Borg & Counter, 1989 t Scientific American Social Engagement
  • 10. Social Engagement and Otis Media? The Face: A Critical Component of a Social Engagement System • At birth the mammalian nervous system needs a “caregiver” to survive and signals the caregiver via the muscles of the face and head. • At term the corticobulbar pathways that regulate the striated muscles of the face are myelinated. • The face is “hardwired” to the neural regulation of visceral state via a mammalian “neural circuit.” • Metabolic demands, stress, trauma and illness retract the “mammalian” neural circuit with the resultant symptoms of a face that does not work and social engagement behaviors are absent. The Social Human Infant Fantz, 1963
  • 11. The Social Human Infant Neonates can discriminate between direct and averted eye gaze and look longer and more frequently at faces with direct eye gaze Farroni, Csibra, Simion, & Johnson (2002). Eye contact detection n humans from birth. Proceedings of the National Academy of Sciences, 99, 9602- 9605. My Child’s Face Does Not Work! Gabriel Metzu, The Sick Child When Other Faces Do Not Work!
  • 12. When the nervous system fails use Botox! Beauty is a journey that starts with a choice… Learn about your Choices Autism People Need People: A Biological Basis for Social Behavior Regulators of physiology are “embedded” in relationships M. Hofer New York State Psychiatric Institute
  • 13. How are the adaptive defensive systems (flight, fight, and freeze), which are mediated by the amygdala and other limbic structures, inhibited to promote the positive spontaneous social behavior associated with the Social Engagement System? Neuroception Life Threat Amygdala (central nucleus) ventrolateral Periaqueductal Gray Freeze Autonomic State (pyramidal tracks) (dorsal vagal regulation) Inhibitory pathways Excitatory pathways Neuroception Danger Amygdala (central nucleus) dorsolateral and lateral Periaqueductal Gray Rostral Caudal Fight Flight (pyramidal tracks) (pyramidal tracks) Autonomic State (sympathetic) Inhibitory pathways Excitatory pathways
  • 14. The Trustworthiness of Faces R. Adolphs, 2002 Neuroception Safe FFA/STS Motor Cortex Amygdala Medulla (central nucleus) (source nuclei V,VII,IX,X,XI) Social Engagement System Somatomotor Visceromotor (muscles of face & head) (heart, bronchi) Inhibitory pathways Excitatory pathways Social Engagement System: Observable Deficits in Several Psychiatric and Behavioral Disorders • Prosody • Gaze • Facial expressivity • Mood and affect • Posture during social engagement
  • 15. The Polyvagal Theory: Insights into the selection of outcome measures Stephen W. Porges, Ph.D. Brain-Body Center University of Illinois at Chicago sporges@uic.edu Acknowledgments Special thanks to: • Olga Bazhenova, Ph.D. • John Denver, Ph.D. • Keri Heilman, M.A. • Jane Sorokin, M.A. • Elgiz Bal Funding provided by: • NIMH Grant MH-60625 • NLMF Family Foundation • Unicorn Children’s Foundation • Cure Autism Now Overview: The Polyvagal Theory • Evolution provides an organizing principle to understand neural regulation of the human autonomic nervous system. • Three neural circuits form a phylogenetically-ordered response hierarchy that regulate behavioral and physiological adaptation to safe, dangerous, and life threatening environments. • “Neuroception” of danger or safety or life threat trigger these adaptive neural circuits. • New models relating neural regulation to health, learning, and social behavior may be reversed- engineered into treatments.
  • 16. Polyvagal Theory: Risk Assessment Environment outside the body inside the body Nervous System Neuroception Safety Danger Life threat Spontaneously engages others Defensive strategies eye contact, facial expression, prosody death feigning/shutdown (immobilization) supports visceral homeostasis Defensive strategies fight/flight behaviors (mobilization) Social Engagement System Observable Deficits in Several Psychiatric and Behavioral Disorders • Prosody • Gaze • Facial expressivity • Mood and affect • Posture during social engagement FXS A compromised social engagement system? http://www.fragilex.org
  • 17. Behavioral Features of FXS • Hyperarousal, distractible, impulsive • Hypoarousal • Difficulties in listening • Sensory defensiveness • sound sensitivities • oral motor defensiveness • Tactile defensiveness/hypersensitivity • Poor eye contact and difficulties in social communication • Speech-language delays (males) • Anxiety • Hypervigilance • Affect regulation (e.g., tantrums) • Shyness • Low cardiac vagal tone http://www.fragilex.org Phylogenetic Organization of the ANS: The Polyvagal Theory head “old” vagus viscera limbs trunk Vasovagal Syncope
  • 18. Phylogenetic Organization of the ANS: The Polyvagal Theory Corticospinal Pathways head Sympathetic Nervous System viscera limbs trunk Mobilization: Flight Behaviors Mobilization: Fight Behaviors
  • 19. Phylogenetic Organization of the ANS: The Polyvagal Theory head Corticobulbar pathways “new” vagus viscera limbs trunk Social Engagement © Jeff Hunter/ The Image Bank Polyvagal Theory: A Phylogenetic Hierarchy of Response Strategies Structure Function VVC SNS DMX Head Communication + Limbs + Mobilization + Viscera Immobilization
  • 20. Social Engagement System Observable Deficits in Several Psychiatric and Behavioral Disorders • Prosody • Gaze • Facial expressivity • Mood and affect • Posture during social engagement Social Engagement System Anatomical basis cortex brainstem Muscles of Head Turning Cranial Nerves Mastication V,VII,IX,X,XI Middle Ear Bronchi Muscles Facial Larynx Pharynx Heart Muscles environment Heart Rate Rhythms: An autonomic component of social engagement RESP 800 RSA HP (ms) 0.10 900 60 BPM 1000 HPV 1100 1200 0 30 60 90 120 SECONDS
  • 21. My Child’s Face Does Not Work! Gabriel Metzu, The Sick Child Looking and Listening Common Neurophysiological Mechanisms Middle Ear Muscles: Role in Extracting Human Voice Borg & Counter, 1989 t Scientific American
  • 22. How are the adaptive defensive systems (flight, fight, and freeze), which are mediated by the amygdala and other limbic structures, inhibited to promote the positive spontaneous social behavior associated with the Social Engagement System? Neuroception Life Threat Amygdala (central nucleus) ventrolateral Periaqueductal Gray Freeze Autonomic State (pyramidal tracks) (dorsal vagal regulation) Inhibitory pathways Excitatory pathways Neuroception Danger Amygdala (central nucleus) dorsolateral and lateral Periaqueductal Gray Rostral Caudal Fight Flight (pyramidal tracks) (pyramidal tracks) Autonomic State (sympathetic) Inhibitory pathways Excitatory pathways
  • 23. The Trustworthiness of Faces R. Adolphs, 2002 Neuroception Safe FFA/STS Motor Cortex Amygdala Medulla (central nucleus) (source nuclei V,VII,IX,X,XI) Social Engagement System Somatomotor Visceromotor (muscles of face & head) (heart, bronchi) Inhibitory pathways Excitatory pathways Social Engagement System: Observable Deficits in Several Psychiatric and Behavioral Disorders • Prosody • Gaze • Facial expressivity • Mood and affect • Posture during social engagement
  • 24. Social Engagement System Where to look? What to measure? Cortex ERP, EEG, EOP, fMRI Autonomic heart rate, vagal tone (RSA), respiration Middle ear muscles impedance words from noise Facial muscles facial EMG, thermography, video coding of faces Laryngeal/pharyngeal acoustic properties of muscles vocalizations, language Gaze eye tracking Control: 12 year old male Eye 57% 106C OFF % EYE % MOUTH % 32.6 57.18 10.22
  • 25. Before Intervention: Autism 10 year old male Eye 1% 111A OFF % EYE % MOUTH % 39.31 1.15 59.54 After Intervention: Autism 10 year old male Eye 71% 119B OFF % EYE % MOUTH % 26.15 71.38 2.47 Fixation Duration Percent 90 80 70 60 50 Pre 40 Post 30 20 10 0 t(19) = -7.343, p <.0001
  • 26. Fixation Duration Percent 70 60 50 Control 40 Pre 30 Post 20 10 0 OFF EYE MOUTH Control/Pre F(1,38) = 39.005***, 69.207***, .219 ns Control/Post F(1,38) = 21.371***, 14.551***, .030 ns SCAN Test 12 10 8 Control 6 Pre Post 4 2 0 SCAN FW SCAN CW Control/Pre F(1,39) = 187.272***, 27.400*** Control/Post F(1,39) = 6.290**, 0.108 ns Respiratory Sinus Arrhythmia (ln msec2) 8 * Control * Pre * Post 7 6 5 4 3 Control/Pre F(1,38) = 16.067*** Control/Post F(1,38) = 3.805 ns Pre/Post F(1,38) = 16.427***
  • 27. What Needs to be Done? •New Populations: Apply the Listing Project interventions to individuals with language delays and older and more severe autistic individuals •Repeated interventions: Change protocol to evaluate the effect of repeated interventions on the trajectory of individuals in existing treatment programs. •Describe the autistic nervous system: Validate neural mechanisms mediating vulnerabilities in social engagement and the behavioral changes following intervention (fMRI, NIRS, ANS, facial EMG & IR thermography) •Expand intervention strategies: Incorporate visual stimuli to trigger multisensory neurons that facilitate language and social communication. Potential Applications of the Polyvagal Theory in Psychiatry, Psychology, and Education ! Aspects of several physical and psychiatric diseases can be explained as emergent properties of the neural regulation of the autonomic nervous system (feedback, evolution, development) ! New diagnostic methods and new treatments can emphasize measurement and manipulation of the neural regulation of the autonomic nervous system. ! Environments can be designed to support the functions of the nervous system with positive impact on social behavior and emotion regulation – Computers that modulate neural regulation of the ANS – Quiet environments – Nervous system “friendly” classrooms – Improved social behavior: People need people – a biological basis Summary • “Neuroception” of safety or danger mediates the beneficial consequences of social behavior. • Autonomic reactions to challenges are organized in a phylogenetically-determined hierarchy. • Various atypical behaviors are adaptive for short periods. • Several psychopathologies are expressed as deficits in the Social Engagement System. • Biologically-based behavioral interventions can trigger neural circuits that mediate positive social behavior.