Neuroendocrine mechanisms involved in the physiological effects caused by skin-to-skin contact – With a particular focus on the oxytocinergic system

The positive clinical effects caused by skin-to-skin contact immediately after birth or after repeated skin-to-skin contact of premature infants (kangaroo care) or fullterm infants are well documented in the literature. However, information regarding the physiological mechanisms mediating these effects are surprisingly scarce and incomplete. In this article the oxytocinergic system and the cutaneous sensory pathways by which the oxytocinergic system is activated in response to skin-to-skin contact are presented in more detail. In addition, we discuss how the effects of skin-to-skin treatment can be attributed to different aspects of the effect spectrum of the oxytocinergic or calm and connection system.The structure of the oxytocinergic system, comprising the peripheral (circulating, hormonal) and the central (neurotransmitter) components, as well as, the pathways and mechanisms by which these functions are coordinated are described. Also the various effects induced by the oxytocinergic system (the calm and connection system) are reviewed.The sensory pathways, which include visual, auditory, olfactory and tactile stimuli, given and received by both mother and newborn and which activate the oxytocinergic system in response to skin-to-skin contact, are reviewed. A special emphasis is placed on the role of cutaneous sensory nerves and their activation by touch, light pressure and in particular warmth. The important role of the rise and the pulsatility of maternal temperature in mediating the positive effects of skin-to-skin contact in the newborn is highlighted. The concept of maternal giving of warmth and its possible link to the experience of trust and safety in the newborn is discussed from an evolutionary perspective.The effects induced by skin-to-skin contact can be attributed to the different functions of the oxytocinergic system. Ameliorated social interaction (e.g., more tactile and auditory interaction, more sensitive and synchronous interaction between mother and baby, the baby’s crawling behavior) are expressions of oxytocin’s ability to stimulate social interaction. The decreased levels of fear and stress are expressions of oxytocin’s ability to reduce the activity of the amygdala and of the stress system, e.g. the activity in the HPA-axis and the sympathetic nervous system. Increased HRV, increased activity in endocrine system of the gastrointestinal tract as well as stimulation of growth and maturation are examples of oxytocin’s ability to stimulate the activity of the parasympathetic nervous system and other peripheral and central mechanisms related to restoration and growth.The propensity of different types of treatment with skin-to-skin contact to induce long-term effects is also highlighted. We propose that the sustained effects caused by skin-to-skin contact are induced by an enduring shift in the balance between the oxytocinergic system (the calm and connection system) and the stress system (fight flight reaction) in favor of the oxytocinergic system. This shift leads to a sustained decrease in the HPA-axis and the sympathetic nervous system probably involving alpha 2-adrenoceptors.It is of clinical importance to be aware of the mechanisms by which skin-to-skin contact induces short and longterm positive effects in parents and newborns. If ward routines are adapted to ascertain a maximal stimulation of these mechanisms, the function of the oxytocinergic system will be optimized, which will be linked to a better clinical outcome for parents and newborns.     

Higher-order cognitive factors affect subjective but not proprioceptive aspects of self-representation in the rubber hand illusion

In the current study we look at whether subjective and proprioceptive aspects of selfrepresentation are separable components subserved by distinct systems of multisensory integration. We used the rubber hand illusion (RHI) to draw the location of the ‘self’ away from the body, towards extracorporeal space (Out Condition), thereby violating top-down information about the body location. This was compared with the traditional RHI which drew position of the ‘self’ towards the body (In Condition). We were successfully able to draw proprioceptive position of the limbs in and out from the body suggesting body perception is a purely bottom-up process, resistant to top-down effects. Conversely, we found subjective self-representation was altered by the violation of top-down body information – as the strong association of subjective and proprioceptive factors found in the In Condition became non-significant in the Out Condition. Interestingly, we also found evidence that subjective embodiment can modulate tactile perception.     

Left caloric vestibular stimulation as a tool to reveal implicit and explicit parameters of body representation

Homeostatic parameters, such as temperature, are related to body representation. In this study, we measured whether caloric vestibular stimulation (CVS) alters body temperature and tactile processing, and if in the direction predicted by a holistic body matrix representation.Skin temperature and tactile two-point discrimination (TPD) acuity were measured for both arms before, immediately after and with a delay from CVS. Participants were also administered a personality questionnaire and an anxiety inventory to rule out confounding factors. Two control experiments were planned to exclude casual variations.Our results show that temperature drops significantly in both arms after CVS. CVS also induces a bilateral improvement in tactile acuity (even though not immediately after but in the delayed condition). Finally, these effects are not due to learning, as demonstrated by the control experiment.In summary, our results suggest that vestibular stimulation updates body representation, supporting the evidence in favor of a body matrix.     

Social touch alters newborn monkey behavior

In humans, infants respond positively to slow, gentle stroking—processed by C-tactile (CT) nerve fibers—by showing reductions in stress and increases in eye contact, smiling, and positive vocalizations. More frequent maternal touch is linked to greater activity and connectivity strength in social brain regions, and increases children’s attention to and learning of faces. It has been theorized that touch may prime children for social interactions and set them on a path towards healthy social cognitive development. However, less is known about the effects of touch on young infants’ psychological development, especially in the newborn period, a highly sensitive period of transition with rapid growth in sensory and social processing. It remains untested whether newborns can distinguish CT-targeted touch from other types of touch, or whether there are benefits of touch for newborns’ social, emotional, or cognitive development. In the present study, we experimentally investigated the acute effects of touch in newborn monkeys, a common model for human social development. Rhesus macaques (Macaca mulatta), like humans, are highly social, have complex mother-infant interactions with frequent body contact for the first weeks of life, making them an excellent model of infant sociality. Infant monkeys in the present study were reared in a neonatal nursery, enabling control over their early environment, including all caregiver interactions. One-week-old macaque infants (N = 27) participated in three 5-minute counter-balanced caregiver interactions, all with mutual gaze: stroking head and shoulders (CT-targeted touch), stroking palms of hands and soles of feet (Non-CT touch), or no stroking (No-touch). Immediately following the interaction, infants watched social and nonsocial videos and picture arrays including faces and objects, while we tracked their visual attention with remote eye tracking. We found that, during the caregiver interactions, infants behaved differently while being touched compared to the no-touch condition, irrespective of the body part touched. Most notably, in both touch conditions, infants exhibited fewer stress-related behaviors—self-scratching, locomotion, and contact time with a comfort object—compared to when they were not touched. Following CT-targeted touch, infants were faster to orient to the picture arrays compared to the other interaction conditions, suggesting CT-targeted touch may activate or prime infants’ attentional orienting system. In the No-touch condition infants attended longer to the nonsocial compared to the social video, possibly reflecting a baseline preference for nonsocial stimuli. In contrast, in both touch conditions, infants’ looked equally to the social and nonsocial videos, suggesting that touch may influence the types of visual stimuli that hold infants’ attention. Collectively, our results reveal that newborn macaques responded positively to touch, and touch appeared to influence some aspects of their subsequent attention, although we found limited evidence that these effects are mediated by CT fibers. These findings suggest that newborn touch may broadly support infants’ psychological development, and may have early evolutionary roots, shared across primates. This study illustrates the unique insight offered by nonhuman primates for exploring early infant social touch, revealing that touch may positively affect emotional and attentional development as early as the newborn period.     

Development of mother–infant interaction in tickling play: The relationship between infants’ ticklishness and social behaviors

This study examined the development of mother–infant tickling interaction and the relationship between infants’ ticklishness and social behaviors including infants’ looking at mothers’ face, mothers’ narrative tickling, and mothers’ laughter. Twenty-two Japanese infants aged 5 months (n = 10, five girls) and 7 months (n = 12, four girls) and their mothers were videotaped. Results revealed that the mothers’ narrative tickling was more frequent at 7 than at 5 months and the infants’ strong ticklishness showed the same tendency. The infants’ strong ticklishness was linked with the occurrence of other social behaviors. In conclusion, infants’ ticklishness was heavily connected with social behaviors. The mode of the tickling interaction at 7 months was different from that at 5 months especially in the increase of mother’s narrative tickling. A possible function of such mother’s narrative tickling to facilitate infant active communication at a higher cognitive level including anticipation, was discussed.     

Tactile detection response task: Metrics for assessing drivers’ cognitive workload

The Tactile Detection Response Task (TDRT) has been used to assess the cognitive workload of driver distraction with response time and miss rate as metrics of cognitive workload. However, it is not clear which metric is more sensitive and whether sensitivity is maintained for visual tasks. The objective of this study was to assess the sensitivity of the TDRT to changes in cognitive workload and to examine whether the sensitivity depends on task modality. A driving simulator study was conducted with 24 participants. The study included restaurant selection tasks with three presentation modalities (auditory, visual, and hybrid) and two difficulty levels (low and high). The high difficulty level was designed to be more cognitively demanding than the low difficulty level. Mixed-effects models were applied to examine the TDRT metrics and task difficulty level. The model controlled for age group, gender, and included a random effect for participants. The high difficulty level of the auditory tasks significantly increased the likelihood of missing a TDRT stimulus. No statistically significant differences were observed for visual and hybrid tasks. TDRT response time was not significantly associated with the difficulty level, regardless of task modality. In this study, the binary outcome TDRT miss was thus considered a more sensitive metric of cognitive workload than TDRT response time. TDRT response time can still be used to measure cognitive workload when tasks are relatively easy and the TDRT miss rate is close to zero. In addition, the sensitivity of the TDRT miss diminished for tasks that involved a visual component. Researchers who use TDRT to measure the cognitive workload associated with visual tasks should be aware of this limitation.     

The effect of visual threat on spatial attention to touch

Viewing a threatening stimulus can bias visual attention toward that location. Such effects have typically been investigated only in the visual modality, despite the fact that many threatening stimuli are most dangerous when close to or in contact with the body. Recent multisensory research indicates that a neutral visual stimulus, such as a light flash, can lead to a tactile attention shift towards a nearby body part. Here, we investigated whether the threat value of a visual stimulus modulates its effect on attention to touch. Participants made speeded discrimination responses about tactile stimuli presented to one or other hand, preceded by a picture cue (snake, spider, flower or mushroom) presented close to the same or the opposite hand. Pictures of snakes led to a significantly greater tactile attentional facilitation effect than did non-threatening pictures of flowers and mushrooms. Furthermore, there was a correlation between self-reported fear of snakes and spiders and the magnitude of early facilitation following cues of that type. These findings demonstrate that the attentional bias towards threat extends to the tactile modality and indicate that perceived threat value can modulate the cross-modal effect that a visual cue has on attention to touch.     

Categorical perception of tactile distance

The tactile surface forms a continuous sheet covering the body. And yet, the perceived distance between two touches varies across stimulation sites. Perceived tactile distance is larger when stimuli cross over the wrist, compared to when both fall on either the hand or the forearm. This effect could reflect a categorical distortion of tactile space across body-part boundaries (in which stimuli crossing the wrist boundary are perceptually elongated) or may simply reflect a localised increased in acuity surrounding anatomical landmarks (in which stimuli near the wrist are perceptually elongated). We tested these two interpretations across two experiments, by comparing a well-documented bias to perceive mediolateral tactile distances across the forearm/hand as larger than proximodistal ones along the forearm/hand at three different sites (hand, wrist, and forearm). According to the ‘categorical’ interpretation, tactile distances should be elongated selectively in the proximodistal axis thus reducing the anisotropy. According to the ‘localised acuity’ interpretation, distances will be perceptually elongated in the vicinity of the wrist regardless of orientation, leading to increased overall size without affecting anisotropy. Consistent with the categorical account, we found a reduction in the magnitude of anisotropy at the wrist, with no evidence of a corresponding localised increase in precision. These findings demonstrate that we reference touch to a representation of the body that is categorically segmented into discrete parts, which consequently influences the perception of tactile distance.     

Differences in practices of body stimulation during the first 3 months: Ethnotheories and behaviors of Italian mothers and West African immigrant mothers

This study investigated cultural differences, continuity and change of practices concerning body stimulation in a context of immigration. Parenting behaviors during the interaction with infants at 4, 8 and 12 weeks, and parenting ethnotheories at 12 weeks of first-generation West African immigrant mothers in Italy and autochthonous Italian mothers were compared. A qualitative inspection of ethnotheories using a thematic approach was included. As expected, results showed that immigrant mothers placed more emphasis on motor stimulation and showed longer durations of rhythmic motor and rhythmic tactile behaviors than Italian mothers; the latter placed more emphasis on tactile stimulation than immigrant mothers. The practice of motor stimulation in immigrant mothers was also adapted to values of the new context of life, becoming a positive interaction game with a mutual exchange of positive emotions. Findings express the complexity of a multidimensional process of acculturation.     

Tactile order memory: evidence for sequence learning phenomena found with other stimulus types

We examine serial order memory for sequences of tactile stimuli and investigate whether established characteristics of order memory, namely serial position effects, error distributions, and Hebb repetition learning, are observed with tactile memory. Visually obscured participants received six tactile stimulations: one to each of six fingers. At test, participants lifted the six fingers in the order of stimulation. For every third trial participants received the same order of stimulation (i.e. the Hebb sequence). Serial recall accuracy produced the canonical bowed serial position function found for immediate serial recall. In addition, recall for the Hebb sequence improved relative to the filler sequences, providing the first demonstration of the Hebb repetition effect with tactile stimuli. Analysis of errors revealed close similarities to that reported with verbal and visual stimuli. This experiment further generalises established features of order memory to tactile memory, supporting the utilisation of an analogous order memory mechanism across stimuli.